Article Text

AB1476-HPR Complications after silicon metocarpophalangeal artroplasty in patiants with rheumatoid arthritis
  1. S. Makarov,
  2. M. Makarov,
  3. Y. Khrennikoff,
  4. M. Lipina,
  5. D. Ivanoff,
  6. V.V. Kolomatsky,
  7. A. Roskidailou
  1. Orthopedic Department, Research Institute of Rheumatology, Moscow, Russian Federation


Background Metacarpophalangeal joint artroplasty in patient with rheumatoid arthritis and another arthritic conditions could improve a range of motion, functional ability and appearance of the hand. Implants used for this procedure commonly made of silicon elastomer. But since their introducing we have a lot of reports about complications. In this abstract we present our analysis of complications after silicom metacarpophalangeal artroplasty (SMPA).The purpose of the study was to evaluate the mid-term results after SMPA in patients with RA.

Objectives The purpose of the study was to assess a complications after SMPA and their influence on result.

Methods From 2004 till 2011 were performed 275 SMPAs. All patients with exception of one man were women. Average age was 39,7 years. Mean follow up was 21,7 months. For 72 imlants (14 women) mean follow up was 4,27 years. Patients were assessed for active range of motion (ROM), extension deficiency and ulnar drift. Futhermore after 12 and 24 months were perform X-ray examination.

Results Mean ROM before operation was 38,4°, average ROM after operation was 54,76°. Average extension deficiency before operations was 27,8°, after - 6,32°. Average ulnar deviation 37° and 7,89° respectively. 84 from 275 implants have a clear signs of the implant damage (subsidence or collapse of the joint space, phalangeal dislocations). But in spite of this there was only 5 revisions (8 imlants) due to unsatisfactory results. In 1 case was a deep infection with implant removing. In 1 case was a bad appearance of the hand (25 years old woman) due to “bayonet” deformity without any loss of function.

Another 3 women (6 imlants) had a silicon sinovitis in II and III fingers due to trauma and overcorrection of the ulnar drift. In these cases imbalance of the soft tissue leads to implant overload and silicon microparticle producing. In these cases imlants were roken and their “color” was significantly differ than in new implant. Biopsy did’t show any signs of “rheumatoud” process.

Conclusions The rate of complications was 2,9% that almost a same in hip and knee arhroplasty. Rate of the implant fractures was 30,9%. All cases of the silicon sinovitis were caused by implant fractures due to bad soft tissue balance and ulnar drift over correction. In spite of complications SMPA has a good satisfactory rate in patients with rheumatic diseases.

Disclosure of Interest None Declared

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