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A Midterm Follow-Up Study of Bioreconstructive Polylactide Scaffold Implants in Metacarpophalangeal Joint Arthroplasty in Rheumatoid Arthritis Patients

From the Center of Rheumatic Diseases, Department of Internal Medicine and Department of Orthopaedics and Physiatrics, Tampere University Hospital, Tampere, Finland, and Medical School University of Tampere, Finland, Institute of Biomaterials, Tampere University of Technology, Tampere, Finland and Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland and Coxa, Hospital for Joint Replacement, Tampere, Finland

Correspondence: Honkanen Pirjo MD, Center of Rheumatic Diseases, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland. Tel.: +358 3 3116 5047; fax: +358 3 3116 3015. E-mail:pirjo.honkanen{at}fimnet.fi.

This paper presents the results of a prospective study of 80 metacarpophalangeal joint arthroplasties, in which biodegradable polylactide 96/4 copolymer scaffolds were used. Twenty-three rheumatoid arthritis patients were assessed at an average of 59 months after operation, which exceeds the resorption time of P(L/D)LA 96/4 according to animal experiments. Palmar subluxation exceeded half of the bone thickness in 39 joints before operation and in nine at the last follow-up. Ulnar deviation decreased from 25° to 5°, extension deficit from 32° to 15° and active flexion from 76° to 63°. The results are comparable with published data on silicone implant arthroplasties. Implant resorption did not induce any significant osteolysis in the medium term and the restoration of the structure and function of the hand was maintained after implant resorption, probably as the guided fibrous tissues had replaced the dissolved implant.

Key Words: metacarpophalangeal joint • rheumatoid arthritis • arthroplasty • implant • surgery

This version was published on April 1, 2009

Journal of Hand Surgery (European Volume), Vol. 34, No. 2, 179-185 (2009)
DOI: 10.1177/1753193408099833


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