Interpositional arthroplasty for rheumatoid carpometacarpal joint disease

Over the past 3 years the Swanson great toe prosthesis was used in an interpositional arthroplasty at the carpometacarpal joint in 21 thumbs of 19 patients with rheumatoid arthritis and three thumbs of two patients with lupus arthritis. In selected patients with advanced disease, this prosthesis has the advantage of allowing for correction of deformity while preserving carpal stock, which may be important if a surgical procedure is required at the wrist. Stable capsular closure does not require reinforcement by adjacent tendon. Twenty-two thumbs of 19 patients were improved, although in three the prosthesis was malpositioned. Two. patients required reoperation and removal of the prosthesis: one for infection, and one for failure to correct deformity. Overall functional results often were affected by the status of disease in other joints, but in general were acceptable.