Pyrolytic carbon MCP arthroplasty: a report of seven prostheses implanted in two patients

Abstract

Rheumatoid arthritis most commonly affects the metacarpophalangeal (MCP) joints of the hand. Pyrolytic carbon MCP arthroplasty has lately provided a new alternative in the treatment of these patients, but reports in the literature are still few. Here, we report the mid-term results of seven such prostheses implanted in two elderly patients with rheumatoid arthritis. Pyrolytic carbon MCP arthroplasty was performed on three MCP joints in one patient and on four MCP joints in another patient. A specific postoperative mobilization protocol was applied. Range of motion, grip strength, and pinch strength were recorded, and radiographs were taken at three, six, and ten months postoperatively. Ten months after the operation, the operated joints were pain-free, and grip and pinch strengths had improved. On average, the passive range of motion had improved and the active range of motion had remained about the same. The joints were clinically stable. No adverse remodeling or bone resorption was observed radiographically. Ulnar deviation recurred in one of the two cases. These results suggest pyrolytic carbon MCP arthroplasty to be a noteworthy alternative in the treatment of MCP joints affected by rheumatoid arthritis. Early treatment, before the development of severe soft tissue destruction, seems to yield better results.