Hand surgery in rheumatoid arthritis: state of the art and suggestions for research

L. Ghattas, F. Mascella and G. Pomponio

Istituto di Clinica Medica, Ematologia ed Immunologia Clinica Azienda Ospedali Riuniti and Università di Ancona, Italy.

Correspondence to: Dr. Giovanni Pomponio, Istituto di Clinica Medica, Ematologia ed Immunologia Clinica, Università di Ancona, Via Conca, 1 60020, Italy. E-mail: pomponio{at}univpm.it


    Abstract
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 
Objective. The role of surgery in the clinical management of patients with rheumatoid arthritis (RA)-associated hand dysfunction is still a subject of controversy. The efficacy of surgery in RA-associated hand dysfunction is assessed through an exhaustive review of published studies.

Methods. A high-sensitivity search strategy was used to identify in MedLine and CENTRAL original studies related to hand and wrist surgery in RA patients. We selected articles including at least two adult RA patients which evaluated clinical outcomes through an observational or experimental design. Eligible studies were evaluated by standardized criteria. Two investigators independently used a pre-defined form to extract data about patient population, intervention, follow-up and clinical outcomes. Disagreements were discussed and resolved.

Results. One hundred and ninety-six papers met inclusion criteria. Only five were randomized trials, while most studies followed an observational design, often of poor quality. As such, we could not pool data for statistical analysis; however, we were still able to provide a best evidence synthesis. A positive trend suggesting the efficacy of total carpal arthrodesis and metacarpophalangeal arthroplasty in reducing pain and improving function seemed to emerge from the published studies.

Conclusions. Despite recent advances in medical treatment, surgery still plays a role in the clinical management of RA-associated hand dysfunction. However, the majority of the available studies showed methodological flaws that prevented a clear definition of both surgical indications and criteria for choosing any specific procedure. Suggestions for further investigations are also provided.

KEY WORDS: Rheumatoid arthritis, Surgical procedures, Operative, Review, Academic


    Introduction
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 
Rheumatoid arthritis (RA) affects a large proportion (from 0.33 to 6.8%) of the adult population [1]. In RA patients, the metacarpophalangeal, proximal interphalangeal, and wrist joints are involved earlier and more frequently than any other joint of the body; this involvement is collectively defined as ‘rheumatoid hand disease’. Destruction of these joints and the surrounding soft tissue results in enormous personal, social and economic impairment. Recent advances in medical treatments have translated into better control of the inflammatory symptoms as well as prevention of joint destruction. The specific role of surgery in clinical management of RA patients needs to be reviewed in the light of this progress. At present, the surgical management of rheumatoid hand disease is still not standardized, with many different approaches being proposed, each one in a relatively small number of published studies. The low quality and the heterogeneity of experimental designs has prevented the definition of universally accepted guidelines for clinical practice. Through a review of the existing literature, and to provide recommendations for clinical practice and suggestions for further investigation, we have here summarized all available information on the efficacy of surgery for rheumatoid hand disease.


    Methods
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 
Literature identification
We conducted a literature search using MedLine and the Cochrane library (CENTRAL) to identify all citations of original research studies related to hand surgery in rheumatoid arthritis. Details of the search strategy are given in Table 1. The search was not limited to publications in English. References from retrieved articles were also hand screened.


View this table:
[in this window]
[in a new window]
 
TABLE 1. Search strategy

 
Selection of studies
Based on title and abstract, two reviewers independently selected the trials to be included in this review; all articles selected by at least one of the reviewers were retrieved for examination. According to an a priori protocol, articles fulfilling all the following inclusion criteria were selected: (1) clinical observational or experimental study design, (2) inclusion of at least two patients with rheumatoid arthritis aged >18 yr, (3) evaluation of any hand or wrist surgical intervention, (4) outcome measures according to the WHO/ILAR core set of endpoints for RA clinical trials [2].

Quality assessment
Randomized controlled trials were evaluated using the validated quality scale suggested by Jadad et al. [3]. A limitation of using this scale as originally developed for drug trials is that in non-pharmacological studies, such as surgical treatment, double blinding is virtually impossible. Therefore we lowered the threshold for poor quality studies to <2 (see Appendix 1). Cohort studies as well as case series were evaluated according to the criteria assessed in the ‘User's guide to the medical literature’ [4–6].

Data extraction
The selected studies were gathered on the basis of anatomical site of intervention: wrist, metacarpophalangeal joints, interphalangeal joints, trapezio-metacarpal joint, hand tendons. The following data were extracted independently by two reviewers: characteristics of study design, population (size, age, gender and duration of disease), intervention (details about surgical procedure), length of follow-up, outcome evaluation and overall clinical results.

Best evidence synthesis
Since methodological flaws prevented statistical pooling, a best evidence synthesis was performed by considering the following levels of evidence:

  1. Convincing (strong) evidence: Presence of at least one randomized clinical trial (RTC). Presence of more than one controlled cohort study (CCS) with concordant results.
  2. Moderate evidence: Presence of one CCS and more than one non-controlled cohort study (NCCS) with concordant results.
  3. Limited evidence: Presence of more than one NCCS with concordant results. Presence of case series or case reports.
  4. Conflicting evidence: Presence of RTCs or CCSs with contrasting results (less than 80% concordance). Presence of one RTC with contrasting results to CCSs.
  5. No evidence: Absence of studies.


    Results
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 
Description of studies
One hundred and ninety-six studies met our inclusion criteria. The design of selected papers is described in Table 2. The reviewed studies were published between 1966 and December 2003; almost all the reviewed studies were case series, often with a number of severe methodological flaws. In particular, in many studies a limited and non-homogeneous group of patients was recruited, with poorly described procedures and limited follow-up; in addition, hard outcomes, such as progression of structural joint damage or long-term disability, were not evaluated. Only five randomized controlled trials were retrieved: four trials evaluated arthroplasty or synovectomy of metacarpophalangeal joints and one trial evaluated carpal synovectomy (Table 3).


View this table:
[in this window]
[in a new window]
 
TABLE 2. Methodological characteristics of randomized controlled trials

 

View this table:
[in this window]
[in a new window]
 
TABLE 3. Study design of retrieved articles

 
Efficacy of surgical procedures
Results are summarized in Table 4.


View this table:
[in this window]
[in a new window]
 
TABLE 4. Efficacy of surgical procedures (see text for details)

 
Wrist
All surgical procedures described in the retrieved studies can be classified according to the degree of joint damage:
  1. early procedures (synovectomy, distal ulna resection, partial arthrodesis)—mild to moderate morphological and structural joint damage;
  2. late procedures (total arthrodesis, carpal arthroplasty)—complete destruction of carpal joint.

Synovectomy [7–28]
Twenty-two studies reported results of wrist synovectomy in a total of 743 RA patients (1120 operated wrists). Almost all reports consisted of single cohort observational studies; in two studies only an untreated cohort of patients was included as control [14–25]. One single randomized clinical trial (RCT) [8] was also retrieved, showing a trend in favour of surgery when compared with medical treatment. Synovectomy was most often performed in patients with refractory active synovitis (pain and swelling), usually at the same time as other wrist surgical procedures, thus complicating the proper evaluation of the effects of synovectomy itself. However, in most patients the surgical procedure was followed by reduction of pain, without changes in the radiological progression of the disease. The main adverse effect of synovectomy was reduction in joint mobility. Some authors concluded that synovectomy contributes to carpal instability and deformity; therefore they suggested that a stabilization procedure (usually partial arthrodesis or tendon transfer) should be performed at the same time as carpal synovectomy [11, 16, 17]. However, to the best of our knowledge, there are no comparative studies on this subject. The percentage of re-intervention due to complications and recurrence of synovitis varied (0–25%) between studies [8, 19, 20, 24].

Resection of distal ulna (Darrach procedure)[16, 19, 20, 23, 24, 26, 29–39]
Seventeen studies (523 RA patients, 726 interventions) have been retrieved. A control cohort was included in 6/17 studies [16, 30, 32–35]. Unfortunately, we observed a wide variability in the characteristics of control groups, which include the contralateral wrist in the same patients [16, 33], or patients with other hand diseases [32, 34]. This feature may explain the heterogeneity of the reported results. Resection of the distal ulna is almost always described in association with other procedures (most often synovectomy and stabilizing surgery) and in patients with ulnar head syndrome refractory to medical treatment in the absence of wrist instability. In all, results of these studies suggest that the Darrach procedure is followed by significant pain reduction and functional improvement, while its efficacy in preventing extensor carpi tendon rupture is unclear. The main complication described is increased instability of the wrist and translocation of the carpi, although only few studies included an appropriate follow-up period [16, 23, 30, 33, 36]. Several authors proposed associating the Darrach procedure with other surgical interventions in order to obtain optimal stabilization of the carpi.

Partial arthrodesis [11, 17, 34, 40–54]
Partial arthrodesis includes procedures such as radio-lunar arthrodesis, scapho-radio-lunar arthrodesis, and the Sauvé–Kapandji procedure. We identified 19 studies evaluating partial arthrodesis in RA patients, for a total of 572 procedures in 422 patients. In 16/19 reports an observational prospective study of non-controlled cohorts was described; in 3/19 reports controls were included, consisting either of unoperated wrists [49], patients with osteoarthritis [34] or patients with total arthrodesis [48]. These procedures were performed in patients with moderate carpal destruction and preservation of the distal carpal bones, and often in association with synovectomy and distal ulnar resection. Reported results included decrease of pain and prevention of further carpal translocation, thus allowing a satisfactory joint mobility; however, these results were hardly maintained in a longer follow-up. Indeed, partial arthrodesis does not seem to influence significantly the long-term progression of the X-ray status. Complications include failure to fuse the arthrodesis and ankylosis of the ulnar pseudoarthrosis in the Sauvé–Kapandji procedure [40, 45].

Radio-carpal or total arthrodesis [48, 55–81]
We selected 28 studies, usually non-controlled prospective cohort studies, reporting the results of 1087 operations in 868 patients, performed from 1975 until 2003. Various procedures were performed to obtain fixation of the articulation. In the three controlled cohort studies comparing the efficacy of various arthrodesis techniques [58, 59, 66] (no RTCs), no significant differences were observed. In another three controlled studies, arthrodesis was compared with other therapeutic options (no operation in the contralateral wrist [61], partial arthrodesis [48], arthroplasty [69]) with inconclusive results. Radio-carpal arthrodesis was performed in patients with severe carpal instability or serious and irreparable damage to the motor tendons of the wrist wherein wrist stability was prioritized over wrist motility (i.e. patients who need deambulation support). Arthrodesis was also described as a salvage procedure after failure of previous wrist surgery. In most cases the procedure was followed by a reduction in pain and functional improvement and its result was considered satisfactory by most patients. In a variable percentage of cases, the lack of arthrodesis fusion was observed [55, 56, 60], although not always associated with the onset of clinical symptoms. Other described complications include the dislocation of the osteosynthesis implements [73, 74] followed by their surgical removal and, in turn, by delayed healing of the surgical wound. The occurrence of these complications was variable, and associated with the type of surgical procedure, the surgeon's experience in this particular procedure, length of follow-up, patient characteristics, and the definition of complications.

Arthroplasty [69, 79, 80, 82–124]
We identified 46 studies, reporting the results of 1755 arthroplastic procedures performed in 1394 patients. In these studies, the procedures more frequently reported are total joint replacement (i.e. Volz, Meuli., etc.) and interposition arthroplasty, most notably the Swanson procedure. Most studies involved a cohort of patients observed prospectively; in three studies [69, 79, 80] a comparison with arthrodesis was performed, yielding inconclusive results as to what is the preferable surgical option. Arthroplasty was performed as an alternative to arthrodesis in patients requiring preservation of wrist mobility over its stability; in these patients the severe damage of the carpal joint was not associated with significant damage to the tendons. In most patients, arthroplasty was followed by reduction in pain and functional improvement. The overall effect of arthroplasty on joint function appeared to be favourable, though the reported outcome measures were heterogeneous. No consistent beneficial effect was reported in terms of increase of gripping force. Reported complications included weakening, dislocation and fracture of the prosthesis [82, 84, 85, 91, 92, 97, 101–103, 105–107, 110–114]; peri-prosthetic bone reabsorption [79, 110] and foreign-body synovitis. The incidence of these complications was variable; occasionally, surgical revision was performed.

Metacarpophalangeal joint
The most commonly performed procedures on the metacarpophalangeal joints are synovectomy and arthroplasty.

Synovectomy [125–130]
We identified six articles in which 50 patients were recruited and more than 160 synovectomy procedures were performed. In one study [125], synovectomy was associated with an autologous bone implant, a procedure that has been performed through arthroscopy in recent years [126, 128]. In two studies, one randomized controlled trial [130] and one cohort study [129], a control group of untreated patients was included. In most cases, synovectomy was performed in the event of persistent pain of joints with mild to moderate deformation and resistance to medical treatment. In the majority of patients (but not in those involved in the randomized controlled trial), a significant reduction of pain was achieved, although the available data do not indicate that synovectomy slows down or interrupts the progression of disease.

Arthroplasty [131–165]
We identified 35 studies involving a total of 1100 patients and 3690 arthroplasty procedures. These studies reported various surgical approaches to arthroplasty as well as different types of prosthesis. Based on the available data, it is not possible to come to any conclusion about whether one surgical technique may be better than the others. Three of the retrieved studies are RCTs in which a comparison is done between different types of prosthesis [141, 145] or with the addition of tendon transfer [133]. These comparisons have also been studied in two controlled cohort studies [139, 151]. Arthroplasty on the metacarpophalangeal joint was performed in the event of serious functional and morphological damage. In the vast majority of patients, the procedure induced reduction in pain of varying degrees as well as functional improvement (measured as flexion and extension of the metacarpophalangeal joint, decrease of ulnar deviation and increase of the gripping force).

Interphalangeal joints
The procedures most commonly performed on the interphalangeal joints are arthrodesis and arthroplasty, usually associated with other surgical procedures on the hand. The choice between these two types of surgery depends on the involvement of adjacent joints.

Arthroplasty [166–176]
We identified 11 non-controlled cohort studies involving 160 patients and a total of 810 arthroplasty procedures on the interphalangeal joint. This procedure was almost always performed on the proximal hand joints using various procedures and often in association with surgery on the adjacent joints. The main limitation of most studies was the enrolment of patients with different joint diseases; this feature explains the reported heterogeneity in terms of results and makes it difficult to assess the specific outcomes of RA patients. Arthroplasty was carried out in patients with persistent pain despite appropriate medical therapy and preserved joint function and morphology. In most patients a significant reduction in pain was obtained, associated with an increased arc motility and correction of the deformed joints, although a trend towards relapse of symptoms was also observed. The most common complication was fracture of the prosthesis [167, 168, 173, 175].

Arthrodesis [177–180]
Only few studies reported arthrodesis (four prospective uncontrolled cohort studies, for a total of 385 operated articulations); this may be due, at least in part, to the fact that this procedure is often carried out together with metacarpophalangeal arthroplasty. The reported results indicate that pain reduction as well as a morphofunctional improvement can be achieved. It is difficult, however, to determine the duration of these clinical benefits.

Tendon
The surgical procedures involved are synovectomy and tendon reconstruction.

Synovectomy [16, 19, 20, 23, 26, 181–188]
We identified 13 uncontrolled cohort studies, of which seven described synovectomy performed on extensory tendons [16, 19, 20, 23, 26, 181, 182] and six on the flexor tendons [183–188]. A total of 450 RA patients were included in these studies. In six studies [16, 19, 20, 23, 26, 185] the procedure was associated with other surgical interventions on the hand and wrist. Synovectomy was proposed to prevent the rupture of tendons and to reduce pain. While this latter effect was observed in most patients, no conclusion can be made on the former due to the absence of controlled studies. The main complication of the procedure is relapse of the synovitis [19, 20, 183, 184, 187, 188].

Tendon reconstruction [189–193]
We identified five uncontrolled cohort studies including a total of 180 surgical procedures. The tendon reconstruction was performed to repair a ruptured tendon in the absence of significant morphofunctional changes to the adjacent joints.

Thumb
We identified 12 uncontrolled cohort studies involving 260 patients and a total of 491 surgical procedures. Two of these studies (for a total of 80 procedures) reported reconstruction of the long extensor of the thumb [194, 195], five cohort studies (for a total of 190 procedures) reported data relative to arthroplastic procedures of the first metacarpophalangeal joint [196–200], one cohort study (for a total of four procedures) reported data relative to arthrodesis of the thumb interphalangeal (IP) joint [180], and four studies (for a total of 117 procedures) [201–204] reported data relative to arthroplasty of the trapezio-metacarpal joint.

In the majority of treated patients, arthroplasty of the first metacarpophalangeal joint appeared to be effective in both reducing pain and improving hand function. However, this conclusion is somehow weakened by the paucity of studies and the marked patient heterogeneity. These caveats also apply to the evaluation of the arthroplasty of the trapezio-metacarpal joint, the thumb IP joint arthrodesis and the surgical repair of the long extensor of the thumb.


    Discussion
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 
Aim of this review is to assess the efficacy of surgery in the management of RA-associated hand disease. Unfortunately, most of the retrieved studies showed methodological flaws: the type of study (i.e. series of cases instead of randomized controlled trials), the recruitment of patients (i.e. heterogeneity in terms of diagnosis) and the criteria used to assess the outcome. As such, we have found it difficult to come up with conclusive answers to our original question. When all these limitations are considered, it is still possible to identify a trend towards clinical efficacy for both total carpal arthrodesis and metacarpophalangeal arthroplasty. Both procedures show some undeniable short-term efficacy in reducing the pain and improving the joint function.

Interestingly, most methodological flaws found in these studies could be avoided in future research. In particular, prospective studies that include a control group should be designed to determine unequivocally whether a particular procedure is better than another procedure or medical treatment alone (i.e. no surgery). In addition, patient recruitment should be more homogeneous in terms of diagnosis, severity of disease and type and length of medical treatment; this would avoid the confusing effect of a mixed patient population. Also, the choice of outcome markers should focus on clinical parameters (i.e. pain reduction, functional improvement, overall patient satisfaction), instead of parameters of unclear clinical significance (i.e. changes in the joint arc motion). Markers of outcome for the surgical treatment of the RA-associated hand disease should be identified and evaluated analogously to the existing markers of outcome for medical treatment [205]. Finally, patients should be post-operatively evaluated at consistent time intervals. This would allow complications to be recorded as they occur and short- and long-term outcomes to be compared.

In conclusion, although the improvement of medical therapy for RA has reduced the need for surgery, there are still selected cases of RA-associated hand disease that require surgical management. Hopefully future research will clarify the relative utility of the individual surgical procedures, thus optimizing the clinical management of hand disease of RA patients.


    Appendix 1
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 
Jadad's modified scale

  1. Is the study randomized?
  2. Is the study double blinded?
  3. Is there a description of withdrawals?
    Assign 1 point if the answer is YES.
    Assign 0 points if the answer is NO.

  1. Is the randomization adequately described?
  2. Is the blindness adequately described?
    Add 1 point for any positive answer.
    Subtract 1 point for any negative answer.
    Score range 0–5
    Good quality trial = score >2.


    Acknowledgments
 
The authors wish to thank Dr Guido Silvestri for his critical reading of this manuscript.

The authors have declared no conflicts of interest.


    References
 Top
 Abstract
 Introduction
 Methods
 Results
 Discussion
 Appendix 1
 References
 

  1. Gabriel SE. The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am 2001;27:269–81.[ISI][Medline]
  2. Boers M, Tugwell P, Felson DT et al. World Health Organization and International League of Associations for Rheumatology core endpoints for symptom modifying anti-rheumatic drugs in rheumatoid clinical trials. J Rheumatol 1994;21(suppl 41): 86–9.
  3. Jadad AR, Moore RA, Carroll D et al. Assessing the quality of reports on randomized clinical trials: is blinding necessary? Controlled Clin Trials 1996;17:1–12.[CrossRef][ISI][Medline]
  4. Laupacis A, Wells G, Richardson WS, Tugwell P for the Evidence-Based Medicine Working Group. How to use an article about prognosis. J Am Med Assoc 1994;272:234–7.[CrossRef][ISI][Medline]
  5. Guyatt GH, Sackett D, Cook DJ, for the Evidence Based Medicine Working Group. How to use an article about therapy or prevention. J Am Med Assoc 1993;270:2598–601.[CrossRef][ISI][Medline]
  6. Guyatt GH, Sackett D, Cook DJ for the Evidence Based Medicine Working Group. How to use an article about therapy or prevention. J Am Med Assoc 1994;271:59–63.[CrossRef][ISI][Medline]
  7. Wei N, Delauter SK, Beard S, Erlichman MS, Henry D. Office-based arthroscopic synovectomy of the wrist in rheumatoid arthritis. Arthroscopy 2001;17:884–7.[ISI][Medline]
  8. Nakamura H, Nagashima M, Ishigami S, Wauke K, Yoshino S. The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis. Int Orthop 2000;24:242–5.[CrossRef][ISI][Medline]
  9. Chantelot C, Fontaine C, Filipo RM, Migaud H, Le Coustumer F, Duquennoy A. Synovectomy combined with the Sauvé-Kapandji procedure for the rheumatoid wrist. J Hand Surg Br 1999;24: 405–9.[CrossRef][Medline]
  10. Teshima R, Hagino H, Kishimoto H, Yamamoto K. Radial and lumbar bone mineral density after wrist synovectomy in rheumatoid arthritis. A minimum 2-year follow-up in 10 unilaterally operated patients. Arch Orthop Trauma Surg 1998;118:78–80.[CrossRef][ISI][Medline]
  11. Chantelot C, Fontaine C, Jardin C, Migaud H, le Coustumer F, Duquennoy A. Radiographic course of 39 rheumatoid wrist after synovectomy and stabilization. Chir Main 1998;17:236–44.[Medline]
  12. Adolfsson L, Frisen M. Arthroscopic synovectomy of the rheumatoid wrist. A 3.8 year follow-up. J Hand Surg Br 1997;22:711–13.[Medline]
  13. Adolfsson L, Nylander G. Arthroscopic synovectomy of the rheumatoid wrist. J Hand Surg Br 1993;18:92–6.[CrossRef][Medline]
  14. Gobel D, Gratz S, von Rothkirch T, Becker W. Chronic polyarthritis and radiosynoviorthesis: a prospective, controlled study of injection therapy with erbium 169 and rhenium 186. Z Rheumatol 1997; 56:207–13.[CrossRef][ISI][Medline]
  15. Aguilera S, Pizzi T, Donoso I. Radiation synovectomy with yttrium 90 and rhenium 186 in rheumatoid arthritis, long term follow-up and effects on synovial membrane. Rev Med Chil 1994;122:1283–8.[ISI][Medline]
  16. Ishikawa H, Hanyu T, Tajima T. Rheumatoid wrists treated with synovectomy of the extensor tendons and the wrist joint combined with a Darrach procedure. J Hand Surg Am 1992;17:1109–17.[Medline]
  17. Alnot JY, Fauroux L. Synovectomy in the realignment-stabilization of the rheumatoid wrist. A propos of a series of 104 cases with average follow-up of 5 years. Rev Rhum Mal Osteoartic 1992;59:196–206.[Medline]
  18. Ochi T, Iwase R, Kimura T et al. Effect of early synovectomy on the course of rheumatoid arthritis. J Rheumatol 1991;18:1794–8.[ISI][Medline]
  19. Brumfield R Jr, Kuschner SH, Gellman H, Liles DN, Van Winckle G. Results of dorsal wrist synovectomies in the rheumatoid hand. J Hand Surg Am 1990;15:733–5.[Medline]
  20. Allieu Y, Lussiez B, Asencio G. Long-term results of surgical synovectomies of the rheumatoid wrist. A propos of 60 cases. Rev Chir Orthop Reparatrice Appar Mot 1989;75:172–8.[ISI][Medline]
  21. Alnot JY, Leroux D. Realignment stabilization synovectomy in the rheumatoid wrist. A study of twenty-five cases. Ann Chir Main 1985;4:294–305.[Medline]
  22. Vahvanen V, Patiala H. Synovectomy of the wrist in rheumatoid arthritis and related diseases. A follow-up study of 97 consecutive cases. Arch Orthop Trauma Surg 1984;102:230–7.[CrossRef][ISI][Medline]
  23. Thirupathi RG, Ferlic DC, Clayton ML. Dorsal wrist synovectomy in rheumatoid arthritis—a long term study. J Hand Surg Am 1983; 8:848–56.[ISI][Medline]
  24. Jensen CM. Synovectomy with resection of the distal ulna in rheumatoid arthritis of the wrist. Acta Orthop Scand 1983; 54:754–9.[ISI][Medline]
  25. Namba H. Clinical results of synovectomy for rheumatoid wrist compared with the opposite side [in Japanese]. Nippon Seikeigeka Gakkai Zasshi 1981;55:527–41.[Medline]
  26. Nordin JY, Benoist M, Pouget G, Cauchoix J. Dorsal tenosynovectomy of the wrist in rheumatoid arthritis. Results obtained in 30 cases. Rev Rhum Mal Osteoartc 1976;43:291–6.
  27. Edstrom B, Lugnegard H, Syk B. X-ray changes in connection with late synovectomy of the hand in rheumatoid arthritis. Scand J Rheumatol 1975;4:92–6.[Medline]
  28. Ito J, Koshino T, Okamoto R, Saito T. Radiologic evaluation of the rheumatoid hand after synovectomy and extensor carpi radialis longus transfer to extensor carpi ulnaris. J Hand Surg Am 2003;28:585–90.[CrossRef][Medline]
  29. Chantelot C. Stability of the forearm after resection of the distal ulna and proximal radius in rheumatoid arthritis: report of 11 cases. Chir Main 2002;21:1–4.[CrossRef][Medline]
  30. Masnada K. Radiographic changes after resection of the distal ulna in patients with rheumatoid arthritis. Scand J Plast Reconstr Surg Hand Surg 2002;36:300–4.[CrossRef][ISI][Medline]
  31. Vispo Seara JL Walther M, Gohlke F. Resection of the head of the ulna in patients with rheumatoid arthritis. Handchir Mikrochir Plast Chir 2000;32:51–7.[CrossRef][Medline]
  32. Fraser KE, Diao E, Peimer CA, Sherwin FS. Comparative results of resection of the distal ulna in rheumatoid arthritis and post-traumatic conditions. J Hand Surg Br 1999;24:667–70.[CrossRef][Medline]
  33. Van Gemert AM. Radiological evaluation of the long-term effects of resection of the distal ulna in rheumatoid arthritis. J Hand Surg Br 1994;19:330–3.[CrossRef][Medline]
  34. Schiltenwolf M, Martini AK, Bernd L, Lukoschek M. Results of resection of the head of the ulna. Z Orthop Ihre Grenzgeb 1992;130:181–7.[ISI][Medline]
  35. White RE Jr. Resection of the distal ulna with and without implant arthroplasty in rheumatoid arthritis. J Hand Surg Am 1986;11: 514–18.[Medline]
  36. Gainor BJ, Schaberg J. The rheumatoid wrist after resection of the distal ulna. J Hand Surg Am 1985;10:837–44.[Medline]
  37. Abernethy PJ, Dennyson WG. Decompression of the extensor tendons at the wrist in rheumatoid arthritis. J Bone Joint Surg Br 1979;61:64–8.[ISI][Medline]
  38. Jain A, Ball C, Nanchahal J. Functional outcome following extensor synovectomy and excision of the distal ulna in patients with rheumatoid arthritis. J Hand Surg Br 2003;28:531–6.[CrossRef][Medline]
  39. Syed AA, Lam WL, Agarwal M, Boome R. Stabilization of the ulna stump after Darrach's procedure at the wrist. Int Orthop 2003;27:235–9.[CrossRef][ISI][Medline]
  40. Low CK, Chew WY. Results of Sauvé-Kapandji procedure. Singapore Med J 2002;43:135–7.[Medline]
  41. Borisch Haussmann P. Results of Kapandji-Sauve operation after distal radius fractures. Handchir Mikrochir Plast Chir 1998;30: 399–405.[Medline]
  42. Vincent KA, Szabo RM, Agee JM. The Sauve-Kapandji procedure for reconstruction of the rheumatoid distal radioulnar joint. J Hand Surg Am 1993;18:978–83.[Medline]
  43. Tran Van F, Obry C, Fardellone P, Decoopman M, Vives P. Rehabilitation of the rheumatoid dorsal wrist by the Sauvé-Kapandji operation combined with a realignment-stabilization synovectomy. Ann Chir Main Memb Super 1993;12:115–22; discussion 123.[Medline]
  44. Taleisnik J. The Sauve-Kapandji procedure. Clin Orthop 1992; 275:110–23.[Medline]
  45. Condamine JL, Lebreton L, Aubriot JH. The Sauve-Kapandji operation. Analysis and results of 69 cases. Ann Chir Main Memb Super 1992;11:27–39.[Medline]
  46. Schill S, Luhr T, Thabe H. Radiolunate arthrodesis of the rheumatoid wrist—mid- and long term results. Z Rheumatol 2002;61:551–9.[CrossRef][ISI][Medline]
  47. Borish N. Radiolunate arthrodesis in the rheumatoid wrist: a retrospective clinical and radiological long-term follow-up. J Hand Surg Br 2002;27:61–72.[CrossRef][Medline]
  48. Rittmeister M, Kandziora F, Rehart S, Kerschbaumer F. Radio-lunar Mannerfelt arthrodesis in rheumatoid arthritis. Handchir Mikrochir Plast Chir 1999;31:266–73.[CrossRef][Medline]
  49. Della Santa D, Chamay A. Radiological evolution of the rheumatoid wrist after radio-lunate arthrodesis. J Hand Surg Br 1995;20:146–54.[Medline]
  50. Marcuzzi A, Cristiani G, Castagnini L, Castagnetti C, Caroli A. Partial arthrodeses of the wrist. Chir Organi Mov 1995;80:157–69.[Medline]
  51. Chamay A, Della Santa D. Radiolunate arthrodesis in rheumatoid wrist [21 cases]. Ann Chir Main Memb Super 1991;10:197–206.[Medline]
  52. Stanley JK, Boot DA. Radio-lunate arthrodesis. J Hand Surg Br 1989;14:283–7.[CrossRef][Medline]
  53. Linscheid RL, Dobyns JH. Radiolunate arthrodesis. J Hand Surg Am 1985;10:821–9.[Medline]
  54. Justen HP, Wessinghage D. Radiolunate arthrodesis in rheumatoid wrist—the modified Chamay technique with broadening of indications [in German]. Z Orthop Ihre Grenzgeb 2003;141:316–21.[CrossRef][ISI][Medline]
  55. Voutilainen N, Juutilainen T, Patiala H, Rokkanen P. Arthrodesis of the wrist with bioabsorbable fixation in patients with rheumatoid arthritis. J Hand Surg Br 2002;27:563–7.[CrossRef][Medline]
  56. Voutilainen NH, Patiala HV, Juutilainen TJ, Rokkanen PU. Long term results of wrist arthrodeses fixed with self-reinforced polylevolatic acid implants in patients with rheumatoid arthritis. Scand J Rheumatol 2001;30:149–53.[CrossRef][ISI][Medline]
  57. Houshian S, Schroder HA. Wrist arthrodesis with the AO titanium wrist fusion plate: a consecutive series of 42 cases. J Hand Surg Br 2001;26:355–9.[CrossRef][ISI][Medline]
  58. Rehak DC, Kasper P, Baratz ME, Hagberg WC, McClain E, Imbriglia JE. A comparison of plate and pin fixation for arthrodesis of the rheumatoid wrist. Orthopedics 2000;3:43–8.
  59. Christodoulou L, Patwardhan MS, Burke FD. Open and closet arthrodesis of the rheumatoid wrist using a modified [Stanley] Steinmann pin. J Hand Surg Br 1999;24:662–6.[CrossRef][Medline]
  60. Zenz P, Obrovsky M, Schwagerl W. Mannerfelt arthrodesis of the wrist join in patients with chronic polyarthritis. A retrospective analysis of 24 cases. Z Orthop Ihre Grenzgeb 1999;137:512–15.[ISI][Medline]
  61. Barbier O, Saels P, Rombouts JJ, Thonnard JL. Long-term functional results of wrist arthrodesis in rheumatoid arthritis. J Hand Surg Br 1999;24:27–31.[CrossRef][Medline]
  62. Beer TA, Turner RH. Wrist arthrodesis for failed wrist implant arthroplasty. J Hand Surg Am 1997;22:685–93.[ISI][Medline]
  63. Chantelot C, Le Coustumer F, Fontaine C, Migaud H, Duquennoy A. Arthrodesis of the wrist in inflammatory arthropathy. Effects of fusion of intercarpal joint spaces on functional results. Ann Chir Main Memb Super 1997;16:198–206.[Medline]
  64. Pech J, Sosna A, Rybka V, Pokorny D. Wrist arthrodesis in rheumatoid arthritis. A new technique using internal fixation. J Bone Joint Surg Br 1996;78:783–6.[Medline]
  65. Craigen MA, Stanley JK. Distal ulnar instability following wrist arthrodesis in men. J Hand Surg Br 1995;20:155–8.[Medline]
  66. Howard AC, Stanley D, Getty CJ. Wrist arthrodesis in rheumatoid arthritis. A comparison of two methods of fusion. J Hand Surg Br 1993;18:377–80.[CrossRef][Medline]
  67. Kobus RJ, Turner RH. Wrist arthrodesis for treatment of rheumatoid arthritis. J Hand Surg Am 1990;15:541–6.[Medline]
  68. Wetzel R, Wessinghage D. Arthrodesis of the wrist joint in patients with polyarthritis. Handchir Mikrochir Plast Chir 1987;19:49–54.[Medline]
  69. Vicar AJ, Burton RI. Surgical management of the rheumatoid wrist-fusion or arthroplasty. J Hand Surg Am 1986;11:790–7.[Medline]
  70. Rayan GM. Wrist arthrodesis. J Hand Surg Am 1986;11:356–64.[Medline]
  71. Ryu J, Watson HK, Burgess RC. Rheumatoid wrist reconstruction utilizing a fibrous nonunion and radiocarpal arthrodesis. J Hand Surg Am 1985;10:830–6.[Medline]
  72. Vahvanen V, Tallroth K. Arthrodesis of the wrist by internal fixation in rheumatoid arthritis: a follow-up study of forty-five consecutive cases. J Hand Surg Am 1984;9:531–6.[Medline]
  73. Papaioannou T, Dickson RA. Arthrodesis of the wrist in rheumatoid disease. Hand 1982;14:12–16.[ISI][Medline]
  74. Mikkelsen OA. Arthrodesis of the wrist joint in rheumatoid arthritis. Hand 1980;12:149–53.[ISI][Medline]
  75. Skak SV. Athrodesis of the wrist by the method of Mannerfelt. A follow-up of 19 patients. Acta Orthop Scand 1982;53:557–9.[ISI][Medline]
  76. Millender LH, Philips C. Combined wrist arthrodesis and metacarpophalangeal joint arthroplasty in rheumatoid arthritis. Orthopedics 1978;1:43–8.[ISI][Medline]
  77. Vahvanen V, Kettunen P. Arthrodesis of the wrist in rheumatoid arthritis. A follow-up study of 62 cases. Ann Chir Gynaecol 1977;66:195–202.[ISI][Medline]
  78. Eiken O, Haga T, Salgeback S. Assessment of surgery of the rheumatoid wrist. Scand J Plast Reconstr Surg 1975;9:207–15.[ISI][Medline]
  79. Brumfield RH Jr, Conaty JP, Mays JD. Surgery of the wrist in rheumatoid arthritis. Clin Orthop 1979;Jul–Aug:159–63.
  80. Murphy DM, Khoury JG, Imbriglia JE, Adams BD. Comparison of arthroplasty and arthrodesis for the rheumatoid wrist. J Hand Surg Am 2003;28:570–6.[CrossRef][Medline]
  81. Masada K, Yasuda M, Takeuchi E, Hashimoto H. Technique of intramedullary fixation for arthrodesis of the wrist in rheumatoid arthritis. Scand J Plast Reconstr Surg Hand Surg 2003;37:155–8.[CrossRef][ISI][Medline]
  82. Rahimtoola Z, Rozing PM. Preliminary results of total wrist arthroplasty using the rws prosthesis. J Hand Surg Br 2003; 28:54–60.[CrossRef][Medline]
  83. Takwale VJ, Nuttall D, Trail IA, Stanley JK. Biaxial total wrist replacement in patients with rheumatoid arthritis. Clinical review, survivorship and radiological analysis. J Bone Joint Surg Br 2002;84:692–9.[CrossRef][Medline]
  84. Divelbiss BJ, Sollerman C, Adams BD. Early results of the Universal total wrist arthroplasty in rheumatoid arthritis. J Hand Surg Am 2002;27:195–204.[CrossRef][Medline]
  85. Schill S, Thabe H, Mohr W. Long term outcome of Swanson prosthesis management of the rheumatic wrist joint. Handchir Mikrochir Plast Chir 2001;33:198–206.[CrossRef][Medline]
  86. Radmer S, Andresen R, Sparmann M. Wrist arthroplasty with a new generation of prostheses in patients with rheumatoid arthritis. J Hand Surg Am 1999;24:935–43.[CrossRef][Medline]
  87. Courtman NH, Sochart DH, Trail IA, Stanley JK. Biaxial wrist replacement. Initial results in the rheumatoid patient. J Hand Surg Br 1999;24:32–4.[CrossRef][Medline]
  88. Skoff H. Palmar shelf arthroplasty, the next generation: distraction/interposition for rheumatoid arthritis of the wrist. Plast Reconstr Surg 1999;104:2068–72; discussion 2073.[ISI][Medline]
  89. Rossello MI, Costa M, Pizzorno V. Experience of total wrist arthroplasty with silastic implants plus grommets. Clin Orthop 1997;342:64–70.[CrossRef][Medline]
  90. Lundborg G, Branemark PI. Anchorage of wrist joint prostheses to bone using the osseointegration principle. J Hand Surg Br 1997;22:84–9.[Medline]
  91. Cobb TK, Beckenbaugh RD. Biaxial total-wrist arthroplasty. J Hand Surg Am 1996;21:1011–21.[Medline]
  92. Fourastier J, Le Breton L, Alnot Y, Langlais F, Condamine JL, Pidhorz L. Guepar's total radio-carpal prosthesis in the surgery of the rheumatoid wrist. A propos of 72 cases reviewed. Rev Chir Orthop Reparatrice Appar Mot 1996;82:108–15.[ISI][Medline]
  93. Lirette R, Kinnard P. Biaxial total wrist arthroplasty in rheumatoid arthritis. Can J Surg 1995;38:51–3.[ISI][Medline]
  94. Meuli HC, Fernandez DL. Uncemented total wrist arthroplasty. J Hand Surg Am 1995;20:115–22.[Medline]
  95. Bosco JA 3rd, Bynum DK, Bowers WH. Long term outcome of Volz total wrist arthroplasties. J Arthroplasty 1994;9:25–31.[CrossRef][Medline]
  96. Stanley JK, Tolat AR. Long-term results of Swanson silastic arthroplasty in the rheumatoid wrist. J Hand Surg Br 1993;18:381–8.[CrossRef][Medline]
  97. Lundkvist L, Barfred T. Total wrist arthroplasty. Experience with Swanson flexible silicone implants, 1982–1988. Scand J Plast Reconstr Surg Hand Surg 1992;26:97–100.[ISI][Medline]
  98. Jolly SL, Ferlic DC, Clayton ML, Dennis DA, Stringer EA. Swanson silicone arthropasty of the wrist in rheumatoid arthritis: a long-term follow-up. J Hand Surg Am 1992;17:142–9.[Medline]
  99. Figgie MP, Ranawat CS, Inglis AE, Sobel M, Figgie HE 3rd. Trispherical total wrist arthroplasty in rheumatoid arthritis. J Hand Surg Am 1990;15:217–23.[Medline]
  100. Koneczny O. Corium-plasty of the wrist joint. Handchr Mikrochir Plast Chir 1989;21:79–84.
  101. Haloua JP, Collin JP, Schernberg F, Sandre J. Arthroplasty of the rheumatoid wrist with Swanson implant. Long-term results and complications. Ann Chir Main 1989;8:124–34.[Medline]
  102. Figgie HE 3rd, Ranawat CS, Inglis AE, Straub LR, Mow C. Preliminary results of total wrist arthroplasty in rheumatoid arthritis using the Trispherical total wrist arthroplasty. J Arthroplasty 1988;3:9–15.[Medline]
  103. Cimino PM, Riordan D, Edmunds JO, Brunet ME, Haddad RJ Jr, Davis MJ. Wrist arthroplasty: a retrospective study. Orthopedics 1987;10:337–41.[ISI][Medline]
  104. Dennis DA, Ferlic DC, Clayton ML. Volz total wrist arthroplasty in rheumatoid arthritis: a long-term review. J Hand Surg Am 1986;11:483–90.[Medline]
  105. Brase DW, Millender LH. Failure of silicone rubber wrist arthroplasty in rheumatoid arthritis. J Hand Surg Am 1986; 11:175–83.[Medline]
  106. Fatti JF, Palmer AK, Mosher JF. The long-term results of Swanson silicone rubber interpositional wrist arthroplasty. J Hand Surg Am 1986;11:166–75.[Medline]
  107. McCombe PF, Millroy PJ. Swanson silastic wrist arthroplasty. A retrospective study of fifteen cases. J Hand Surg Br 1985;10: 199–201.[CrossRef][Medline]
  108. Robertson GA, Bailey BN. Silastic sheet interposition arthroplasty for the painful rheumatoid wrist: a long-term review. Br J Plast Surg 1985;38:190–6.[CrossRef][ISI][Medline]
  109. Summers B, Hubbard MJ. Wrist joint arthroplasty in rheumatoid arthritis: a comparison between the Meuli and Swanson prostheses. J Hand Surg Br 1984;9:171–6.[Medline]
  110. Nylen S, Sollerman C, Haffajee D, Ekelund L. Swanson implant arthroplasty of the wrist in rheumatoid arthritis. J Hand Surg Br 1984;9:295–9.[Medline]
  111. Volz RG. Total wrist arthroplasty. A clinical review. Clin Orthop 1984;187:112–20.[Medline]
  112. Schernberg F, Gerard Y, Collin JP, Teinturier P. Arthroplasty of the rheumatoid wrist by silicone implants. Experience with forty cases. Ann Chir Main 1983;2:18–26.[Medline]
  113. Allieu Y, Asencio G, Brahin B, Gomis R, Bahri H. First results of arthroplasty of the wrist by Swanson's implant. Twenty five cases. Ann Chir Main 1982;1:307–18.[Medline]
  114. Davis RF, Weiland AJ, Dowling S. Swanson implant arthroplasty of the wrist in rheumatoid arthritis. Clin Orthop 1982;166:132–7.[Medline]
  115. Pastacaldi P. Perichondrial wrist arthroplasty—a follow-up study in 17 rheumatoid patients. Ann Plast Surg 1982;9:146–51.[ISI][Medline]
  116. Meuli HC. Arthroplasty of the wrist. Clin Orthop 1980;149:118–25.[Medline]
  117. Lamberta FJ, Ferlic DC, Clayton ML. Volz total wrist arthroplasty in rheumatoid arthritis: a preliminary report. J Hand Surg Am 1980;5:245–52.[ISI][Medline]
  118. Goodman MJ, Millender LH, Nalebuff ED, Phillips CA. Arthroplasty of the rheumatoid wrist with silicone rubber: an early evaluation. J Hand Surg Am 1980;5:114–21.[ISI][Medline]
  119. Beckenbaugh RD. Total joint arthroplasty. The wrist. Mayo Clin Proc 1979;54:513–15.[ISI][Medline]
  120. Pastacaldi P, Engkvist O. Perichondrial wrist arthroplasty in rheumatoid patients. Hand 1979;11:184–90.[ISI][Medline]
  121. Jackson IT, Simpson RG. Interpositional arthroplasty of the wrist in rheumatoid arthritis. Hand 1979;11:169–75.[ISI][Medline]
  122. Schill S, Thabe H. [Modular-physiological wrist arthroplasty in rheumatoid arthritis] Orthopade 2003;32:803–8.[CrossRef][ISI][Medline]
  123. Radmer S, Andresen R, Sparmann M. Total wrist arthroplasty in patients with rheumatoid arthritis. J Hand Surg Am 2003;28:789–94.[CrossRef][Medline]
  124. Kretschmer F, Wannske M. The BIAX total wrist prosthesis as an alternative to arthrodesis in degenerative and posttraumatic arthritis–early results in twenty-one patients]. Handchir Mikrochir Plast Chir 2003;35:31–42.[CrossRef][Medline]
  125. Lo CY, Chang YP. Osteochondral grafting of the metacarpophalangeal joint in rheumatoid arthritis. J Hand Surg Br 2003;28:94–7.[CrossRef][Medline]
  126. Sekiya I, Kobayashi M, Taneda Y, Matsui N. Arthroscopy of the proximal interphalangeal and metacarpophalangeal joints in rheumatoid hands. Arthroscopy 2002;18:292–7.[Medline]
  127. Brumm C, Looser M, Kissling RO. Is open synovectomy of the metacarpophalangeal joint in chronic polyarthritis worthwhile? Z Orthop Ihre Grenzgeb 2000;138:496–500.[CrossRef][ISI][Medline]
  128. Wei N, Delauter SK, Erlichman MS, Rozmaryn LM, Beard SJ, Henry DL. Arthroscopic synovectomy of the metacarpophalangeal joint in refractory rheumatoid arthritis: a technique. Arthroscopy 1999;15:265–8.[Medline]
  129. de Carvalho A, Graudal H, Jorgensen B, Vaeth M. Radiologic evaluation of synovectomy in rheumatoid arthritis. Acta Radiol Diagn Stockh 1981;22:505–9.[Medline]
  130. Arthritis and Rheumatism Council and British Orthopaedic Association. Controlled trial of synovectomy of knee and metacarpophalangeal joints in rheumatoid arthritis. Ann Rheum Dis 1975;35:437–42.[ISI][Medline]
  131. Mandl LA, Galvin DH, Bosch JP et al. Metacarpophalangeal arthroplasty in rheumatoid arthritis: what determines satisfaction with surgery? J Rheumatol 2002;29:2488–91.[ISI][Medline]
  132. Clark DI, Delaney R, Stilwell JH, Trail IA, Stanley JK. The value of crossed intrinsic transfer after metacarpophalangeal silastic arthroplasty: a comparative study. J Hand Surg Br 2001;26:565–7.[CrossRef][ISI][Medline]
  133. Pereira JA, Belcher HJ. A comparison of metacarpophalangeal joint silastic arthroplasty with or without crossed intrinsic transfer. J Hand Surg Br 2001;26:229–34.[CrossRef][ISI][Medline]
  134. Ishikawa H, Murasawa A, Hanyu T. The effect of activity and type of rheumatoid arthritis on the flexible implant arthroplasty of the metacarpophalangeal joint. J Hand Surg Br 2002;27:180–3.[CrossRef][Medline]
  135. Gotze JP, Jensen CH. Follow-up of volar plate interposition arthroplasty [Tupper] of the metacarpophalangeal joints in rheumatoid hands: preliminary findings. Scand J Plast Reconstr Surg Hand Surg 2000;34:249–51.[CrossRef][ISI][Medline]
  136. Schmidt K, Willburger R, Ossowski A, Miehlke RK. The effect of the additional use of grommets in silicone implant arthroplasty of the metacarpophalangeal joints. J Hand Surg Br 1999;24:561–4.[CrossRef][Medline]
  137. Colville RJ, Nicholson KS, Belcher HJ. Hand surgery and quality of life. J Hand Surg Br 1999;24:263–6.[CrossRef][Medline]
  138. Schmidt K, Willburger RE, Miehlke RK, Witt K. Ten-year follow-up of silicone arthroplasty of the metacarpophalangeal joints in rheumatoid hands. Scand J Plast Reconstr Hand Surg 1999;33: 433–8.[CrossRef][ISI][Medline]
  139. Rittmeister M, Porsch M, Starker M, Kerschbaumer F. Metacarpophalangeal joint arthroplasty in rheumatoid arthritis: results of Swanson implants and digital joint operative arthroplasty. Arch Orthop Trauma Surg 1999;119:190–4.[CrossRef][ISI][Medline]
  140. Cook SD, Beckenbaugh RD, Redondo J, Popich LS, Klawitter JJ, Linscheid RL. Long-term follow-up of pyrolytic carbon metacarpophalangeal implants. J Bone Joint Surg Am 1999;81:635–48.[Abstract/Free Full Text]
  141. McArthur PA, Milner RH. A prospective randomized comparison of Sutter and Swanson silastic spacers. J Hand Surg Br 1998;23:574–7.[CrossRef][Medline]
  142. Gellman H, Stetson W, Brumfield RH Jr, Costigan W, Kuschner SH. Silastic metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis. Clin Orthop 1997;342:16–21.[CrossRef][Medline]
  143. Hansraj KK, Ashworth CR, Ebramzadeh E et al. Swanson metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis. Clin Orthop 1997;342:11–15.[CrossRef][Medline]
  144. Rothwell AG, Cragg KJ, O'Neill LB. Hand function following silastic arthroplasty of the metacarpophalangeal joints in the rheumatoid hand. J Hand Surg Br 1997;22:90–3.[Medline]
  145. Sollerman CJ, Geijer M. Polyurethane versus silicone for endoprosthetic replacement of the metacarpophalangeal joints in rheumatoid arthritis. Scand J Plast Reconstr Surg Hand Surg 1996;30:145–50.[ISI][Medline]
  146. Ruther W, Verhestraeten B, Fink B, Tillmann K. Resection arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis. Results after more than 15 years. J Hand Surg Br 1995;20:707–15.[Medline]
  147. Vezina P, Gagnon S, Beaumont P, Page JM, Machuca C, Grenier N. Functional study of Swanson's metacarpophalangeal arthroplasties in rheumatoid arthritis. Ann Chir 1995;49:775–8.[ISI][Medline]
  148. Vermeiren JA, Dapper MM, Schoonhoven LA, Merx PW. Isoelastic arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis: a preliminary report. J Hand Surg Am 1994;19:319–24.[Medline]
  149. Lundborg G, Branemark PI, Carlsson I. Metacarpophalangeal joint arthroplasty based on the osseointegration concept. J Hand Surg Br 1993;18:693–703.[CrossRef][Medline]
  150. Wilson YG, Sykes PJ, Niranjan NS. Long-term follow-up of Swanson's silastic arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis. J Hand Surg Br 1993;18:81–91.[CrossRef][Medline]
  151. el-Gammal TA, Blair WF. Motion after metacarpophalangeal joint reconstruction in rheumatoid disease. J Hand Surg Am 1993; 18:504–11.[Medline]
  152. Kirschenbaum D, Schneider LH, Adams DC, Cody RP. Arthroplasty of the metacarpophalangeal joints with use of silicone-rubber implants in patients who have rheumatoid arthritis. Long-term results. J Bone Joint Surg Am 1993;75:3–12.[Abstract]
  153. Lynch A, Colville J. Metacarpophalangeal joint arthroplasty of the rheumatoid hand. Ir Med J 1987;80:58–60.[ISI][Medline]
  154. Vahvanen V, Cazzabubbolo GG, Viljakka T. Silicone rubber implant arthroplasty of the metacarpophalangeal joint in rheumatoid arthritis: a follow-up study of 32 patients. J Hand Surg Am 1986;11:333–9.[Medline]
  155. Bieber EJ, Weiland AJ, Volenec-Dowling S. Silicone-rubber implant arthroplasty of the metacarpophalangeal joints for rheumatoid arthritis. J Bone Joint Surg Am 1986;68:206–9.[Abstract]
  156. Jensen CM, Boeckstyns ME, Kristiansen B. Silastic arthroplasty in rheumatoid MCP-joints. Acta Orthop Scand 1986;57:138–40.[ISI][Medline]
  157. Fleming SG, Hay EL. Metacarpophalangeal joint arthroplasty eleven year follow-up study. J Hand Surg Br 1984;9:300–2.[Medline]
  158. Poulenas I, Simonetta C, Egloff DV. Long-term results from metacarpophalangeal arthroplasty. Ann Chir Main 1983;2:160–7.[Medline]
  159. Kay AG, Jeffs JV, Scott JT. Experience with silastic prostheses in the rheumatoid hand. A 5-year follow-up. Ann Rheum Dis 1978;37:255–8.[Abstract]
  160. Opitz JL, Linscheid RL. Hand function after metacarpophalangeal joint replacement in rheumatoid arthritis. Arch Phys Med Rehabil 1978;59:160–5.[ISI][Medline]
  161. Mannerfelt L, Andersson K. Silastic arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis. J Bone Joint Surg Am 1975;57:484–9.[Abstract]
  162. Honkanen PB, Kellomaki M, Lehtimaki MY, Tormala P, Makela S, Lehto MU. Bioreconstructive joint scaffold implant arthroplasty in metacarpophalangeal joints: short-term results of a new treatment concept in rheumatoid arthritis patients. Tissue Eng 2003;9:957–65.[CrossRef][ISI][Medline]
  163. Radmer S, Andresen R, Sparmann M. Poor experience with a hinged endoprosthesis [WEKO] for the metacarpophalangeal joints: all 28 prostheses removed within 2 years in 8 patients having rheumatoid arthritis. Acta Orthop Scand 2003;74:586–90.[CrossRef][ISI][Medline]
  164. Goldfarb CA, Stern PJ. Metacarpophalangeal joint arthroplasty in rheumatoid arthritis. A long-term assessment. J Bone Joint Surg Am 2003;85A:1869–78.[ISI]
  165. Erdogan A, Weiss AP. [NeuFlex silastic implant in metacarpophalangeal joint arthroplasty]. Orthopade 2003;32:789–93.[CrossRef][ISI][Medline]
  166. Johnstone BR. Proximal interphalangeal joint surface replacement arthroplasty. Hand Surg 2001;6:1–11.[CrossRef][Medline]
  167. Lundborg G, Branemark PI. Osseointegrated proximal interphalangeal joint prostheses with a replaceable flexible joint spacer–long-term results. Scand J Plast Reconstr Surg 2000;34:345–53.[CrossRef][ISI]
  168. Moller K, Sollerman C, Geijer M, Branemark PI. Early results with osseointegrated proximal interphalangeal joint prostheses. J Hand Surg Am 1999;24:267–74.[CrossRef][Medline]
  169. Ashworth CR, Hansraj KK, Todd AO et al. Swanson proximal interphalangeal joint arthroplasty in patients with rheumatoid arthritis. Clin Orthop 1997;342:34–7.[CrossRef][Medline]
  170. Linscheid RL, Murray PM, Vidal MA, Beckenbaugh RD. Development of a surface replacement arthroplasty for proximal interphalangeal joints. J Hand Surg Am 1997;22:285–98.
  171. Adamson GJ, Gellman H, Brumfield RH Jr, Kuschner SH, Lawler JW. Flexible implant resection arthroplasty of the proximal interphalangeal joint in patients with systemic inflammatory arthritis. J Hand Surg Am 1994;19:378–84.[Medline]
  172. Hunter JM, Sattel A, Kirkpatrick WH. Dacron collateral ligament reconstruction with proximal interphalangeal joint arthroplasty. Semin Arthroplasty 1991;2:148–52.[Medline]
  173. Zimmerman NB, Zimmerman SI, Wilgis EF. Distal interphalangeal joint silicone interpositional arthroplasty: surgical technique and functional outcome. Semin Arthroplasty 1991;2:153–7.[Medline]
  174. Condamine JL, Benoit JY, Comtet JJ, Aubriot JH. Proposed digital arthroplasty critical study of the preliminary results. Ann Chir Main 1988;7:282–97.[Medline]
  175. Swanson AB, Maupin BK, Gajjar NV, Swanson GD. Flexible implant arthroplasty in the proximal interphalangeal joint of the hand. J Hand Surg Am 1985;10:796–805.[Medline]
  176. Scott FA, Boswick JA Jr. Palmar arthroplasty for the treatment of the stiff swan-neck deformity. J Hand Surg Am 1983;8:267–72.[ISI][Medline]
  177. Sabbagh W, Grobbelaar AO, Clarke C, Smith PJ, Harrison DH. Long-term results of digital arthrodesis with the Harrison-Nicolle peg. J Hand Surg Br 2001;26:568–71.[CrossRef][ISI][Medline]
  178. Leibovic SJ, Strickland JW. Arthrodesis of the proximal interphalangeal joint of the finger: comparison of the use of the Herbert screw with other fixation methods. J Hand Surg Am 1994;19: 181–8.[Medline]
  179. Katzman SS, Gibeault JD, Dickson K, Thompson JD. Use of a Herbert screw for interphalangeal joint arthrodesis Clin Orthop 1993;296:127–32.[Medline]
  180. Lamas Gomez C, Proubasta I, Escriba I, Itarte J, Caceres E. Distal interphalangeal joint arthrodesis: treatment with Herbert screw. J South Orthop Assoc 2003;12:154–9.[Medline]
  181. Ryu J, Saito S, Honda T, Yamamoto K. Risk factors and prophylactic tenosynovectomy for extensor tendon ruptures in the rheumatoid hand. J Hand Surg Br 1998;23:658–61.[CrossRef][Medline]
  182. Brown FE, Brown ML. Long-term results after tenosynovectomy to treat the rheumatoid hand. J Hand Surg Am 1988;13:704–8.[Medline]
  183. Tolat AR, Stanley JK, Evans RA. Flexor tenosynovectomy and tenolysis in longstanding rheumatoid arthritis. J Hand Surg Br 1996;21:538–43[Medline]
  184. Wheen DJ, Tonkin MA, Green J, Bronkhorst M. Long-term results following digital flexor tenosynovectomy in rheumatoid arthritis. J Hand Surg Am 1995;20:790–4.[Medline]
  185. Duche R, Canovas F, Thaury MN, Bouges S, Allieu Y. [Tenosynovectomy of the flexors in rheumatoid polyarthritis. Analytic study of short term and long term mobility of the fingers.] Ann Chir Main Memb Super 1993;12:85–92.[Medline]
  186. Ferlic DC, Clayton ML. Flexor tenosynovectomy in the rheumatoid finger. J Hand Surg Am 1978;3:364–7.[Medline]
  187. Millis MB, Millender LH, Nalebuff EA. Stiffness of the proximal interphalangeal joints in rheumatoid arthritis. The role of flexor tenosynovitis. J Bone Joint Surg Am 1976;58:801–5.[Abstract]
  188. Dahl E, Mikkelsen OA, Sorensen JU. Flexor tendon synovectomy of the hand in rheumatoid arthritis. A follow-up study of 201 operated hands. Scand J Rheumatol 1976;5:103–7.[ISI][Medline]
  189. Aubert JP, Mattei JP, Legre R, Roux H, Magalon G. Ruptures of the tendons of the hand and wrist in rheumatoid arthritis. J Chir [Paris] 1994;131:420–2.[ISI][Medline]
  190. Moore JR, Weiland AJ, Valdata L. Tendon ruptures in the rheumatoid hand: analysis of treatment and functional results in 60 patients. J Hand Surg Am 1987;12:9–14.[Medline]
  191. Nakamura S, Katsuki M. Tendon grafting for multiple extensor tendon ruptures of fingers in rheumatoid hands. J Hand Surg Br 2002;27:326–8.[CrossRef][Medline]
  192. Mountney J, Blundell CM, McArthur P, Stanley D. Free tendon interposition grafting for the repair of ruptured extensor tendons in the rheumatoid hand. A clinical and biomechanical assessment. J Hand Surg Br 1998;23:662–5.[CrossRef][Medline]
  193. Lu L, Li Q, Xin W. Close injury of the tendon at wrist [in Chinese]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 1997;11:283–5.[Medline]
  194. Winckler S, Westphal T, Brug E. Transposition of the extensor indicis tendon in reconstruction of thumb extension after rupture of the extensor pollicis longus tendon. Chirurg 1995;66:507–12.[ISI][Medline]
  195. Albers U, Bultmann U, Buck-Gramcko D. Replacement of the long extensor tendon of the thumb by transposition of the index finger extensor tendon. Handchir Mirkrochie Plast Chir 1992;24:124–30.
  196. Minami M, Yamazaki J, Kato S, Ishii S. Alumina ceramic prosthesis arthroplasty of the metacarpophalangeal joint in the rheumatoid hand. A 2–4-year follow-up study. J Arthroplasty 1988;3:157–66.[Medline]
  197. McGovern RM, Shin AY, Beckenbaugh RD, Linscheid RL. Long-term results of cemented Steffee arthroplasty of the thumb metacarpophalangeal joint. J Hand Surg Am 2001;26:115–22.[CrossRef][Medline]
  198. Figgie MP, Inglis AE, Sobel M, Bohn WW, Fisher DA. Metacarpal-phalangeal joint arthroplasty of the rheumatoid thumb. J Hand Surg Am 1990;15:210–16.[Medline]
  199. Ferlic DC, Serot DI, Clayton ML. The use of the Flatt hinge prosthesis in the rheumatoid thumb. Hand 1978;10:94–8.[ISI][Medline]
  200. Swanson AB, Herndon JH. Flexible [silicone] implant arthroplasty of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am 1977;59:362–8.[Abstract]
  201. Jennings CD, Livingstone DP. Convex condylar arthroplasty of the basal joint of the thumb: failure under load. J Hand Surg Am 1990;15:573–81.[Medline]
  202. Hay EL, Bomberg BC, Burke C, Misenheimer C. Long-term results of silicone trapezial implant arthroplasty. J Arthroplasty 1988; 3:215–23.[Medline]
  203. Tillmann K, Thabe H. Kessler arthroplasty of the carpometacarpal joint of the thumb in arthrosis and arthritis. Handchirurgie 1979; 11:109–12.[Medline]
  204. Poppen NK, Niebauer JJ. ‘Tie-in’ trapezium prosthesis: long-term results. J Hand Surg Am 1978;3:445–50.[Medline]
  205. Felson DT, Anderson JJ, Boers M et al. American college of rheumatology preliminary definition of improvement in rheumatoid arthritis. Arthritis Rheum 1995;38:727–35.[ISI][Medline]
Submitted 6 December 2004; revised version accepted 22 February 2005.



This Article
Abstract
Full Text (PDF)
All Versions of this Article:
44/7/834    most recent
keh608v1
Alert me when this article is cited
Alert me if a correction is posted
Services
Email this article to a friend
Similar articles in this journal
Similar articles in ISI Web of Science
Similar articles in PubMed
Alert me to new issues of the journal
Add to My Personal Archive
Download to citation manager
Disclaimer
Request Permissions
Google Scholar
Articles by Ghattas, L.
Articles by Pomponio, G.
PubMed
PubMed Citation
Articles by Ghattas, L.
Articles by Pomponio, G.
Related Collections
Rheumatoid Arthritis