Resection arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis. Results after more than 15 years.
In a retrospective study of resection arthroplasty of the MP joints in rheumatoid arthritis, 23 patients (32 hands, 128 joints) have been followed for 15 to 22 years. Patient satisfaction was high, and all patients had significant pain relief. Active motion of the joints averaged 35 degrees, ranging from full extension to 35 degrees of flexion. Ankyloses developed in five hands (13 joints, 10%). Ulnar deviation of more than 15 degrees occurred in six patients (ten hands, 30%). Over the course of several years a significant remodelling of the joints was to be observed. In six hands (19%) the metacarpal heads became spontaneously restored to ball-shaped geometry. Gross metacarpal resorption was observed in nine hands (30%), causing significant shortening of the metacarpals. In one-third of patients the final result was rated as good, fair and poor, respectively. Careful patient selection is mandatory. Patients with mutilating arthritis should be excluded from the procedure; rheumatoid destruction of the wrist joint definitely influences the final result.
Orthopädische Abteilung, Rheumaklinik Bad Bramstedt, Germany.
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W
Rüther
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Verhestraeten
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B
Fink
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K
Tillmann
D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001178:Arthroplasty / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies