Abstract
Resection arthroplasty of the metacarpophalangeal joints stabilized by a Swanson-Silastik®-spacer is the golden standard in MP joint destruction in R.A. 102 arthroplasties of the metacarpophalangeal joint were assessed in 28 rheumatoid patients (34 hands) 10.1 years postoperatively on the average. All patients reported on marked relief of pain. Functional improvement of the hand was found in 75% of the patients. Active range of motion decreases from 42° preoperatively to 36° postoperatively on the average. Ulnar drift was corrected from an average of 34° preoperatively to 12° postoperatively. The average extension deficit had improved from 33° at surgery to 11° at the time of follow-up. Grip strength remained unchanged. The radiographical findings showed surrounding osteolysis in 89.4% of the implants and 27.5% broken spacers. The well known discrepancy of fair clinical and good subjective results with distinct radiographical findings like osteolysis was confirmed. Sharp bony edges as a result of osteolysis may be, besides material fatigue, the reason for increasing implant fracture and ulnar deviation in comparison with medium-term studies.
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