A prospective randomized comparison of Sutter and Swanson silastic spacers

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Rheumatology

Background:

• Rheumatoid arthritis frequently affects joints, necessitating reconstructive surgery.
• Effective joint prostheses are crucial for restoring function and improving quality of life in rheumatoid arthritis patients.

Purpose of the Study:

• To compare the clinical outcomes of Swanson and Sutter prostheses in rheumatoid joint reconstruction.
• To evaluate the efficacy of these prostheses in improving joint mobility, grip strength, and patient-reported outcomes.

Main Methods:

• A randomized controlled trial involving 72 patients undergoing resection arthroplasty.
• Random allocation to either Swanson or Sutter prosthesis by a single surgeon.
• Preoperative and 6-month, 12-month postoperative assessments including flexion arc, grip strength, extensor lag, and patient satisfaction.

Main Results:

• The Swanson group showed significant improvement in flexion arc at 6 months (44 degrees) compared to preoperative (29 degrees), though it decreased slightly by 12 months (36 degrees).
• No significant change in flexion arc was observed in the Sutter group.
• Grip strength improved in the Swanson group but not in the Sutter group. Extensor lag improved in both groups.
• Both prostheses resulted in high patient satisfaction regarding pain, function, and deformity.

Conclusions:

• The Swanson prosthesis demonstrated superior short-term functional benefits in rheumatoid joint reconstruction compared to the Sutter prosthesis.
• Both prostheses offer high patient satisfaction, but the Swanson implant appears more effective in restoring joint mobility and grip strength.