COMPARATIVE STUDY OF METACARPOPHALANGEAL JOINT ARTHROPLASTY EFFECTIVENESS IN PATIENTS WITH RHEUMATOID HAND

Objective - to determine the optimal implant for metacarpophalangeal joint arthroplasty in patients with rheumatoid hand. Materials and methods. 24 patients with rheumatoid hand were operated in Vreden Russian Research Institute of Traumatology and Orthopedics (St.-Petersburg, Russia). 37 MCPJ arthroplasties were performed with 129 implants of 3 types. First group consisted of 11 patients with 43 implanted NeuFlex "DePuy International Ltd." silicone implants on 12 hands. Second group - 6 patients with 26 implants Daphne "TECRES S.p.A." on 7 hands. Third group - 16 patients with 60 implants RM Finger "MATHYS AG Bettlach" on 17 hands. Criteria for treatment effectiveness were estimated taking into account hand function, complications and also relapse of deformation. We compared movement amplitude in MCP joins, angle of ulnar drift, strength of hand and also subjective assessment by patients with DASH. Results were fixed before surgery and 3, 6 and 12 months after. Results. Complications were recorded in I and II of patient groups in 50% of cases: fractures of components, dislocations of construction, relapse of ulnar drift. Complications in III group of patients were not detected. Range of motion and function improvement were increased in all groups (p>0,05), as well as strength of hand. But the most stable growth of hand strength was fixed only in III group (p<0,05). Relapse of ulnar drift occurred in I group of patients. Conclusion. RM Finger "MATHYS AG Bettlach" is more reliable for metacarpophalangeal joint arthroplasty since it provides stable long-term results of treatment.