10-YEAR-RESULTS OF MP JOINT ARTHROPLASTY USING SWANSON SILASTIK(R) SPACERS

Resection arthroplasty of the metacarpophalangeal joints stabilized by a Swanson-Silastik(R)-spacer is the golden standard in MP joint destr uction in R.A. 102 arthroplasties of the metacarpophalangeal joint wer e assessed in 28 rheumatoid patients (34 hands) 10.1 years postoperati vely on the average. Ail patients reported on marked relief of pain. F unctional improvement of the hand was found in 75% of the patients. Ac tive range of motion decreases from 42 degrees preoperatively to 36 de grees postoperatively on the average. Ulnar drift was corrected from a n average of 34 degrees preoperatively to 12 degrees postoperatively. The average extension deficit had improved from 33 degrees at surgery to 11 degrees at the time of follow-up. Grip strength remained unchang ed. The radiographical findings showed surrounding osteolysis in 89.4% of the implants and 27.5% broken spacers. The wellknown discrepancy o f fair clinical and good subjective results with distinct radiographic al findings like osteolysis was confirmed. Sharp bony edges as a resul t of osteolysis may be, besides material fatigue, the reason for incre asing implant fracture and ulnar deviation in comparison with medium-t erm studies.