gms | German Medical Science

In 80% of patients with rheumatoid arthritis the metacarpophalangeal (MP) joints are involved with increasing destruction and loss of function. Silicone arhtroplasty of the MP joints produces a limited range of motion, increasing osteolysis and fractures of the implants. The cementless, unconstrained design of the Elogenics^TM prosthesis is a new concept for treating the MP joints of rheumatoid patients. It will be shown short and midlong results.

In a prospective study 72 Elogenics^TM prosthesis were implanted, 62 in patients with rheumatoid arthritis, osteoarhtritis (n=4), polyarthitis (n=5) and 1 after revision of a silicone implant. The patients were reexamined after an average follow up of 21 months (12-51 months) clinically and radiologically.

The average active range of motion for extension to flexion increased from 0/18/65° before surgery to 0/14/71° after surgery. The remaining ulnar drift was 12° (preoperative 18°). Pain in the verbal analogue scale improved from 2.3 to 1.7 postoperatively. Eight palmar luxations of the implants were recognized. No infection occurred. The X-rays showed a complete osteointegration in all metacarpal components. Radiolucent zones were found in progress only at the basis on the palangeal components without radiologic signs of loosing or sunking.

The short- and midterm results after implantation the cementless, unconstrained Elogenics^TM prosthesis show an improved hand function and pain relieve. The design of the implant may solve the accepted postoperative problem of instability of the MP joints.