Alumina ceramic prosthesis arthroplasty of the metacarpophalangeal joint in the rheumatoid hand. A 2-4-year follow-up study.
Swanson's finger implant is being widely used to improve deformity of the thumb and finger and to restore function in the rheumatoid hand. Breakage of the implant and implant synovitis have been the most troublesome complications. The authors developed an alumina ceramic finger prosthesis to lessen these complications. This prosthesis was used for the metacarpophalangeal joint in 5 cases of flexion deformity of the thumb and in 21 cases (82 digits) with ulnar drift deformity. These cases were followed for 24-62 months (average, 38 months). Postoperative extension of the thumb was limited to 18 degrees and flexion was 48 degrees, on average. Postoperative range of motion was 30 degrees. The average limitation of extension of all digits was 18 degrees, and the average flexion was 54.5 degrees. The average range of motion was 36.5 degrees. Flexion deformity of the metacarpophalangeal joint of the thumb disappeared after operation, and ulnar drift was reduced to less than 10 degrees deviation in 87.8%. No dislocation or fracture of the prosthesis has been found on roentgenologic examination during short-term follow-up study. This prosthesis is useful for reducing deformity of the thumb and the finger in the rheumatoid hand. Postoperative extension of the metacarpophalangeal joint, however, has been unsatisfactory. The design of the prosthesis should be improved so that the rotational center of the metacarpophalangeal joint is located palmarly.
Minami
M
M
Hokkaido Orthopedic Memorial Hospital, Sapporo, Japan.
Yamazaki
J
J
Kato
S
S
Ishii
S
S
D000328:Adult; D000368:Aged; D000535:Aluminum; D000537:Aluminum Oxide; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002516:Ceramics; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D006227:Hand Deformities, Acquired / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008662:Metacarpophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D011474:Prosthesis Design
D000535:Aluminum; D000537:Aluminum Oxide