title: Range of motion of the metacarpophalangeal joint in rheumatoid patients, with and without a flexible joint replacement prosthesis, compared with normal subjects.
abstract: BACKGROUND
  The metacarpophalangeal is commonly affected by rheumatoid arthritis. This may lead to joint replacement with a flexible prosthesis. The aims of this study were to determine the effects of rheumatoid arthritis on joint motion and to determine whether joint replacement needs to restore the full range of motion.
  
  
  METHODS
  Three-dimensional motion analysis was used to measure the range of motion of the metacarpophalangeal joint in rheumatoid patients with and without a flexible silicone arthroplasty, when performing pinch and key grips, when making a fist and when spreading the fingers. The results were compared with those from younger and older normal subjects.
  
  
  RESULTS
  There appeared to be a trend for a decrease in range of motion from younger normal to older normal to rheumatoid (no prosthesis) to rheumatoid (with prosthesis) subject groups. However, statistically different (p<0.05) results were only observed for some movements (mostly involved in making a fist), in some fingers and between some subject groups. The only exception to this apparent trend was in flexion/extension when spreading the fingers into abduction.
  
  
  CONCLUSIONS
  Making a fist is the most sensitive simple measure of range of motion in the metacarpophalangeal joint. Successful replacement of the metacarpophalangeal joint in patients with rheumatoid arthritis need not restore the normal range of motion.
authors.affiliation: School of Mechanical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.
authors.forename: L E
authors.initials: LE
authors.lastname: Lester
authors.forename: J W
authors.initials: JW
authors.lastname: Bevins
authors.forename: C
authors.initials: C
authors.lastname: Hughes
authors.forename: A
authors.initials: A
authors.lastname: Rai
authors.forename: H
authors.initials: H
authors.lastname: Whalley
authors.forename: M
authors.initials: M
authors.lastname: Arafa
authors.forename: D E T
authors.initials: DE
authors.lastname: Shepherd
authors.forename: D W L
authors.initials: DW
authors.lastname: Hukins
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001172:Arthritis, Rheumatoid / Q000503:physiopathology* / Q000601:surgery*; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007595:Joint Prosthesis; D008297:Male; D008662:Metacarpophalangeal Joint / Q000503:physiopathology*; D008875:Middle Aged; D016059:Range of Motion, Articular; D012016:Reference Values; D016896:Treatment Outcome; D055815:Young Adult