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Silicone arthroplasty improves activities of daily living for RA patients

Issue: October 2012

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CHICAGO – Patients who undergo silicone metacarpophalangeal joint arthroplasty for severe subluxation or ulnar drift of the fingers at the metacarpophalangeal joints caused by rheumatoid arthritis showed improvements in hand function and appearance, according to a presenter at the American Society for Surgery of the Hand 2012 Meeting, here.

“Silicone arthroplasty patients reported durable improvement in patient-reported outcomes when considering activities of daily living, hand appearance and overall satisfaction,” Kevin C. Chung, MD, MS, said. “It effectively improved ulnar drift, extension lag and metacarpophalangeal arc of motion up to 3 years of prospective follow-up. Complications following SMPA at 3 years are infrequent.”

 

Kevin C. Chung

Chung and researchers examined 67 surgical and 95 nonsurgical patients with severe subluxation or ulnar drift of the fingers at the metacarpophalangeal (MCP) joint between 2004 and 2008 with a mean follow-up of 3 years. They measured outcomes using the Michigan Hand Outcomes Questionnaire (MHQ), Arthritis Impact Measurement Scales (AIMS2), grip/pinch strength and Jebsen-Taylor test as well as measuring extensor lag and arc of motion at the MCP joints.

The mean MHQ score and function, activities of daily living, aesthetics and satisfaction scores as well as ulnar deviation, extensor lag and arc of motion in the MCP and proximal interphalangeal joint significantly improved in the surgical group compared to the non-surgical group. There were no significant differences in demographic data between groups and no improvement in AIMS2 or grip/pinch strength. The prosthesis fracture rate was 9.5%.

“My message to all of us […] is that silicone arthroplasties should be considered for rheumatoid arthritis patients with severe metacarpophalangeal deformity,” Chung said.

Reference:

Waljee JF, Burns PB, Kim HM, et al. A long-term multi-center outcomes study of silicone metacarpophalangeal joint arthroplasty in rheumatoid arthritis. Paper #3. Presented at the American Society for Surgery of the Hand 2012 Meeting. Sept. 6-8. Chicago.

Disclosure: Chung has no relevant financial disclosures.