title: Bioreconstructive joint scaffold implant arthroplasty in metacarpophalangeal joints: short-term results of a new treatment concept in rheumatoid arthritis patients.
abstract: Swanson silicone implant is the "gold standard" of metacarpophalangeal joint reconstruction in rheumatoid arthritis (RA) patients. However, durability problems of silicone implants have led us to develop a new technique based on bioreconstructive implants. PLA96 (poly-L,D-lactide copolymer, L:D ratio of 96:4) scaffolds were engineered. Bioabsorption and substitution of porous PLA96 scaffold with living tissue eventually produce a neojoint. In the current prospective study, 23 RA patients (80 joints) were operated on, using PLA96 implants. Fifteen patients (54 joints) have been monitored for at least 1 year. Pain alleviation was well achieved. Range of motion improvement was emphasized to extension direction of functional arc. The average ulnar deviation was preoperatively 26 degrees, and at follow-up it was 6 degrees. Volar subluxation was noticeable in 56% of joints preoperatively and in 6% at 1-year follow-up. This is the first report of the formation of a living, functional joint in situ by means of a synthetic bioreconstructive joint scaffold. Results of this preliminary short-term study are comparable with previously published data on silicone arthroplasty. However, bioreconstructive prostheses can aid in preventing problems that occur with biostable prostheses. Tissue engineering has created a new era in the reconstruction of damaged joints.
authors: Division of Orthopedics, Department of Surgery and Department of Physiatrics, Tampere University Hospital and Medical School University of Tampere, Tampere, Finland. pirjo.honkanen@fimnet.fi
authors: P B
authors: PB
authors: Honkanen
authors: M
authors: M
authors: Kellomäki
authors: M Y
authors: MY
authors: Lehtimäki
authors: P
authors: P
authors: Törmälä
authors: S
authors: S
authors: Mäkelä
authors: M U K
authors: MU
authors: Lehto
mesh_terms: D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D001178:Arthroplasty; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery*