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SAT0113 Total metacarpo-pharangeal arthroplasty in ra
  1. N Murata1,
  2. M Saito2,
  3. S Wakitani2,
  4. K Imoto2,
  5. K Masada3,
  6. M Goto4,
  7. Y Komatsubara5
  1. 1Rheumatology
  2. 2Orthopedics, Osaka-Minami National Hospital, Kawachinagano
  3. 3Orthopedics, Osaka Rosai Hospital, Sakai
  4. 4Rheumatology, Otsuka Capital Hospital, Tokyo, Japan
  5. 5Orthopedics, Yukioka Hospital, Osaka


Background It is no exaggeration to say that most of the patients with rheumatoid arthritis (RA) suffer from finger’s sysfunction. Although the total arthroplasty for hip joint and knee joint have brout great benefit for RA patients, total arthroplasty for the upper tremity has not be developed enough. We have contrived new total metacarpo-phrangeal arthroplasty (TMPA) for 4 years and half.

Objectives TMPA have been done in 126 patients (136 hands);106 RA, 16 post-injury, 4 others.

Methods TMP joint is composed with the metacarpal head made of titanium and polyethylene socket with stem. Socket stem is capable to slide into titanium sleeve that is fixed in basal pharangeal cavity with cement.

Results In RA patients TMPA have been done in 106 patients, 114 hands (85 right hands and 29 left hands), 14 thumbs and 291 fingers. Revision was done in 5 patients and removal of TMP joint was done in 6 patients for technical errors in most cases. But the cause of revision in 2 cases is breakage of the polyethylene stem, so we are amending it now.

Conclusion We have contrived new TMP joint and have done TMPA in 106 RA patients, 114 hands, 14 thumbs and 291 fingers. Polyethylene breakage occurred in 2 fingers, so reinforcement of polyethylene stem is necessary.

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