Is Swanson prosthesis better than Sutter prosthesis for metacarpophalangeal joint arthroplasty? A meta-analysis

The aim of this meta-analysis is to compare the outcomes of the Swanson and Sutter prostheses (previously the Avanta prosthesis) used for metacarpophalangeal joint arthroplasty, and provide a powerful and rational conclusion regarding the use of prosthesis in MCP joint surgery. The literature search was based on PubMed, Cochrane Library, MEDLINE, EMBASE, and the Chinese National Knowledge Infrastructure. Data were evaluated using a generic evaluation tool designed by the Cochrane Bone, Joint, and Muscle Trauma Group and analysed using RevMan, version 5.0. Six randomised controlled trials were contained in this review, and five of them involving 143 patients were included in the meta-analysis. The results suggested that using the Sutter prosthesis could significantly decrease the rates of recurrence of drift when compared with the Swanson prosthesis for metacarpophalangeal joint arthroplasty (OR = 2.05, 95% Confidence interval (CI) = 1.31-3.20, p = 0.002). No significant difference in the outcomes of prosthesis fracture was found in two groups (OR = 1.07, 95% CI = 0.41-2.79, p = 0.88). Due to the limited data, the outcomes of range of motion, correction of ulnar deviation, pain, grip strength, and radiographic osteolytic changes could not be included in the meta-analyses. Theoretically, recurrence of drift was more common with Swanson prosthesis when compared with the Sutter prosthesis. No significant difference in the outcomes of prosthesis fracture was observed in two groups. More high-quality studies are required in long-term follow-up.