Revision Metacarpophalangeal Arthroplasty: A Longitudinal Study of 128 Cases

Eric R. Wagner, Matthew T. Houdek, Benjamin Packard, Steven Lawrence Moran, Marco Rizzo

Research output: Contribution to journalArticle

Abstract

PURPOSE: The objective was to examine outcomes associated with a large cohort of revision metacarpophalangeal (MCP) arthroplasties. METHODS: A review of 128 revision MCP arthroplasties performed in 64 patients was performed. The mean age at surgery was 62 years. Fifty nonconstrained (31 pyrocarbon and 19 surface-replacing arthroplasty) and 78 constrained silicone implants were used for revisions. RESULTS: At a follow-up of 6 years (2 to 16), 20 (16%) implants required a secondary revision surgery. The 5- and 10-year survival rates were 81% and 79%, respectively. Postoperative dislocation occurred in 17 (13%) MCP joints. Subgroup analysis demonstrated a 5-year survival rate of 67% in surface-replacing arthroplasties, compared with 83% for both pyrocarbon and silicone implants (hazard ratio, 2.60; P = 0.09). Clinical improvements in pain and MCP range of motion were noted in most patients postoperatively. CONCLUSIONS: Revision MCP arthroplasty is a challenging procedure with one in five patients requiring a revision procedure at 5 years and a relatively high rate of postoperative dislocations. However, most patients who did not undergo a secondary revision surgery experienced improvements in pain and range of motion. Worse outcomes are seen in patients with a history of MCP dislocations.Level IV.

Original languageEnglish (US)
Pages (from-to)211-218
Number of pages8
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume27
Issue number6
DOIs
StatePublished - Mar 15 2019

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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