Long-term results of cemented Steffee arthroplasty of the thumb metacarpophalangeal joint

A retrospective evaluation of the Steffee metacarpophalangeal (MCP) thumb j oint prostheses was performed to determine the long-term outcome and surviv orship of the prosthesis. Fifty-four primary thumb arthroplasties (49 patie nts) were performed for pain, weakness, or instability involving the thumb MCP joint secondary to arthritis. Underlying etiology included rheumatoid ( 49 thumbs), psoriatic (1 thumb), scleroderma (2 thumbs), and degenerative ( 2 thumbs) arthritis. Thirty-one thumbs had concomitant interphalangeal join t instability and underwent interphalangeal joint fusions. At an average fo llow-up period of 57 months, the average motion of the MCP joint was 21 deg rees (range, 0 degrees to 40 degrees), with a significant improvement in po sition and stability. Thumb axis length was maintained or increased in 98%. Although there was not a consistent long-term improvement in grip or pinch strength, 87% of the patients reported subjective improvement in strength and function as a result of surgery. Pain was relieved in all thumbs with p reoperative pain. Complications included a periprosthetic fracture, 2 late infections, and 1 gross loosening of the implant. The survivorship of the i mplant was 93% survivorship at 5 years and 89% survivorship at 10 years, wi th only 4 failures in 54 thumbs. The Steffee thumb MCP arthroplasty resulte d in excellent long-term survivorship, patient satisfaction, and functional outcome. (J Hand Surg 2001;26A:115-122. Copyright (C) 2001 by the American Society for Surgery of the Hand.).