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 language | English (US) |
|---|---|
| Pages (from-to) | 211-218 |
| Number of pages | 8 |
| Journal | The Journal of the American Academy of Orthopaedic Surgeons |
| Volume | 27 |
| Issue number | 6 |
| DOIs | |
| State | Published - Mar 15 2019 |
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ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
Revision Metacarpophalangeal Arthroplasty : A Longitudinal Study of 128 Cases. / Wagner, Eric R.; Houdek, Matthew T.; Packard, Benjamin; Moran, Steven Lawrence; Rizzo, Marco.
In: The Journal of the American Academy of Orthopaedic Surgeons, Vol. 27, No. 6, 15.03.2019, p. 211-218.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Revision Metacarpophalangeal Arthroplasty
T2 - A Longitudinal Study of 128 Cases
AU - Wagner, Eric R.
AU - Houdek, Matthew T.
AU - Packard, Benjamin
AU - Moran, Steven Lawrence
AU - Rizzo, Marco
PY - 2019/3/15
Y1 - 2019/3/15
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85062718411&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062718411&partnerID=8YFLogxK
U2 - 10.5435/JAAOS-D-17-00042
DO - 10.5435/JAAOS-D-17-00042
M3 - Article
C2 - 30272593
AN - SCOPUS:85062718411
VL - 27
SP - 211
EP - 218
JO - Journal of the American Academy of Orthopaedic Surgeons
JF - Journal of the American Academy of Orthopaedic Surgeons
SN - 1067-151X
IS - 6
ER -