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Joint registry database study shows 80% survivorship at 5 years for revision MCP arthroplasty

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LAS VEGAS — Results presented here revealed that revision metacarpophalangeal arthroplasty carries around an 80% survivorship at 5 years and patients with a history of a dislocation and post-traumatic arthritis with primary arthroplasty had slightly higher rates of revision failure.

“There is a high rate of [metacarpophalangeal] MCP joint instability, but using a pyrocarbon or silicone implant seems to have slightly improved outcomes compared to the [surface replacement arthroplasty] SRA,” Eric R. Wagner, MD, said during his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “Furthermore, when considering performing an MCP arthroplasty in the revision setting, it does seem to be able to produce predictable pain relief, improvements in arc of motion and relatively good overall implant survival.”

To determine the outcomes of revision MCP arthroplasty and to find potential factors that improve the results of this procedure, Wagner and his colleagues used the total joint registry at their institution to identify 128 revision MCP arthroplasties performed during a 14-year period. The patients had an average age 62 of years and 85% had preoperative diagnosis of inflammatory arthritis.

Eric R. Wagner

In breaking down survivorship by implant type, the investigators found 5-year survivor rates of approximately 83% when silicone or pryocarbon implants were used vs. 67% when an SRA implant was used. When investigators examined complications, they found that most of the repeat revision surgeries were secondary to dislocation.

“Furthermore, the majority of the complications seen in our cohort in general were MCP dislocations. When looking at factors that contributed to the increased rates of dislocation, we found that SRA implants had a significantly increased rate of instability when compared to pyrocarbon or silicone.” – by Gina Brockenbrough, MA

Reference:

Wagner ER, et al. Paper #111. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-27; Las Vegas.

Disclosure: Wagner reports that one of his co-authors, Steven L. Moran, MD, has relevant financial disclosures.