Hand function after metacarpophalangeal joint replacement in rheumatoid arthritis

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Hand Surgery

Background:

• Rheumatoid arthritis (RA) causes destructive joint changes, often affecting the metacarpophalangeal (MCP) joints.
• MCP joint replacement is a surgical option for severe RA impacting hand function.
• The Swanson Silastic rubber prosthesis is utilized for MCP joint arthroplasty.

Purpose of the Study:

• To evaluate the functional outcomes of total metacarpophalangeal joint replacement using Swanson prostheses in patients with rheumatoid arthritis.
• To compare hand function before and after surgery at different postoperative intervals.

Main Methods:

• A comparative study involving two groups of rheumatoid arthritis patients undergoing MCP joint replacement.
• Group 1: 10 patients assessed 3-4 months post-surgery. Group 2: 11 patients assessed 6-12 months post-surgery.
• Standardized tests were used to measure hand function, including tip prehension, grasp, lateral prehension, pinch force, and power grip.

Main Results:

• Significant postoperative improvements were observed in tip prehension and grasp.
• Lateral prehension, pinch force, and power grip showed minimal to no change after surgery.
• The study included 43 prosthetic procedures across 12 hands in the evaluated patient groups.

Conclusions:

• Swanson Silastic rubber MCP joint prostheses can substantially improve specific aspects of hand function, such as tip prehension and grasp, in rheumatoid arthritis patients.
• A comprehensive postoperative rehabilitation program including therapeutic exercises, functional activities, and splinting is crucial for optimizing outcomes.
• Further evaluation of long-term functional changes and the role of rehabilitation is warranted.