SWANSON METACARPOPHALANGEAL JOINT ARTHROPLASTY IN PATIENTS WITH RHEUMATOID-ARTHRITIS

Between 1981 and 1991, 348 Swanson metacarpophalangeal replacements we re implanted in patients with rheumatoid arthritis, There were 64 fema le and seven male patients, Both hands were reconstructed in 18 patien ts, Clinically, 170 implants were available for an average of 5.2 year s (range, 2-10 years) followup, Severe synovitis was seen in 7% of met acarpophalangeal pophalangeal joints, moderate synovitis in 25%, sligh t synovitis in 17%, and synovitis was not present in 51%, Pain was fou nd to be severe in 4% of the joints, moderate in 3%, slight in 39%, an d not present in 54% of the joints, The average preoperative active ar e of motion was 38 degrees, and the average postoperative are of motio n was 27 degrees, Eleven of 12 fractures found were revised, There wer e no infections. Functionally, of 58 patients assessed, 58 (100%) repo rted the ability to feed themselves, 55 (94%) to button clothes, and 5 4 (93%) to write, Quality radiographs were available in 144 joints, Ei ghty-four percent of implants showed sclerosis of bone and 8% showed r esorption adjacent to the implant, Survivorship analysis revealed a 94 % success rate at 5 years, 93% at 7 years, and 90% at 10 years using t he end point of revision surgery.