Interpositional arthroplasty for rheumatoid carpometacarpal joint disease

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Biomaterials Science

Background:

• Carpometacarpal joint arthritis, particularly rheumatoid arthritis, significantly impacts hand function.
• Traditional treatments may not always preserve adjacent structures or correct deformities effectively.

Purpose of the Study:

• To evaluate the efficacy and outcomes of using the Swanson great toe prosthesis for interpositional arthroplasty in the carpometacarpal joint.
• To assess the prosthesis's ability to correct deformity while preserving carpal structures in patients with inflammatory arthritis.

Main Methods:

• Retrospective analysis of 24 cases (21 rheumatoid arthritis, 3 lupus arthritis) over 3 years.
• Utilized the Swanson great toe prosthesis for interpositional arthroplasty at the carpometacarpal joint.
• Assessed functional outcomes, deformity correction, and complication rates.

Main Results:

• Twenty-two thumbs (19 patients) showed functional improvement.
• Prosthesis malposition occurred in three cases.
• Two patients required reoperation: one for infection, one for failed deformity correction.

Conclusions:

• The Swanson great toe prosthesis offers a viable option for carpometacarpal joint arthroplasty in selected patients with advanced inflammatory arthritis.
• It allows for deformity correction and preserves carpal stock, potentially aiding future wrist surgery.
• While generally acceptable, outcomes can be influenced by the overall disease status and potential complications like malposition or infection.