title: Silicone arthroplasty for nonrheumatic metacarpophalangeal joint arthritis.
abstract: OBJECTIVE
  To evaluate the clinical effectiveness of metacarpophalangeal (MCP) arthroplasty for nonrheumatic arthritis. We hypothesized that MCP arthroplasty would produce significant improvement in objective measures of hand function, pain relief, and overall patient satisfaction.
  
  
  METHODS
  This retrospective study evaluated 30 patients with 38 MCP arthroplasties for nonrheumatic arthritis over a 12-year period. Follow-up assessment was completed at an average of 56 months after surgery. Objective measures included range of motion; grip and pinch strength; Disabilities of the Arm, Shoulder, and Hand (DASH) score; and visual analog pain score. A subjective patient questionnaire was used to assess patient satisfaction.
  
  
  RESULTS
  There was marked improvement between preoperative and follow-up range of motion, DASH, and pain. Linear regression showed strong correlations between preoperative measurements and improvement at follow-up. No difference was detected for grip or pinch strength. Results of the questionnaire showed that 73% were very satisfied, 87% would definitely do it again, and 70% experienced rare or no pain. Follow-up x-rays showed 5° mean angulation and 2-mm mean subsidence compared with immediate postoperative x-rays. Four arthroplasties (11%) required revision.
  
  
  CONCLUSIONS
  This study showed improved range of motion and DASH score, excellent pain relief, and excellent patient satisfaction in patients undergoing MCP arthroplasty for nonrheumatic arthritis. Patients with more severe range of motion limitation, DASH score, and pain score experienced a greater improvement of these measures at follow-up. Strength improvement was limited although it remained comparable to the nonoperated hand. Angulation, subsidence, and complications in the study population were consistent with those reported in the literature.
  
  
  METHODS
  Therapeutic III.
authors.affiliation: Departments of Orthopaedic Surgery and Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh; and the Hand and UpperEx Center, University of Pittsburgh School of Medicine, Wexford, PA.
authors.forename: Mithun K
authors.initials: MK
authors.lastname: Neral
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Pittner
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Spiess
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Imbriglia
mesh_terms: D000328:Adult; D000368:Aged; D050806:Arthroplasty, Replacement, Finger / Q000379:methods*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007595:Joint Prosthesis; D016014:Linear Models; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012828:Silicones; D016896:Treatment Outcome
chemical_list: D012828:Silicones
keywords: Arthritis; arthroplasty; implant; metacarpophalangeal; osteoarthritis