scholarly journals Sites of fractures in explanted NeuFlex® silicone metacarpophalangeal joint prostheses

2018 ◽  
Vol 43 (10) ◽  
pp. 1083-1087 ◽  
Author(s):  
Thomas J. Joyce ◽  
Grey Giddins
Keyword(s):  
Failure Modes ◽  
Clinical Performance ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Silicone Implant ◽  
Silicone Implants ◽  
Single Piece ◽  
Joint Prostheses ◽  
Distal Stem

Single-piece silicone implants dominate metacarpophalangeal joint arthroplasty. The NeuFlex® implant was introduced to improve on the clinical performance of other silicone implants by having a pre-flexed hinge. By visually examining a cohort of 30 explanted NeuFlex® metacarpophalangeal joint prostheses we sought to identify the failure modes of these implants. Seven were not fractured, 11 had fractured across the hinge, nine had fractured at the junction of the distal stem and the hinge, and three showed fractures at both the hinge and at the junction of the distal stem and the hinge. These data may prove helpful in identifying how the performance of single-piece silicone implant designs can be improved.

Bioreconstructive Poly-L/D-Lactide Implant Compared With Swanson Prosthesis in Metacarpophalangeal Joint Arthroplasty in Rheumatoid Patients: a Randomized Clinical Trial

2010 ◽  
Vol 35 (9) ◽  
pp. 746-753 ◽  
Author(s):  
P.B. Honkanen ◽  
R. Thonen ◽  
E.T. Skyttä ◽  
M. Ikävalko ◽  
M.U.K. Lehto ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Study ◽  
Randomized Clinical Trial ◽  
Joint Destruction ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Silicone Implant ◽  
Clinical Assessments ◽  
Randomized Clinical Study

It was hypothesized that the bioresorbable interposition implant might offer a viable alternative to conventional silicone implant arthroplasty in rheumatoid metacarpophalangeal joint destruction. A randomized clinical study was performed to compare a stemless poly-L/D-lactide copolymer 96: 4 (PLDLA) implant with the Swanson silicone implant. Results in 52 patients (53 hands and 175 joints) at a mean follow-up of 2 years (minimum 1 year) showed that the improvement in clinical assessments was comparable in both groups, except for better maintenance of palmar alignment in the Swanson group. The lack of implant fractures and intramedullary osteolysis were advantages of the PLDLA implant. The bioresorbable PLDLA interposition implant may offer an alternative tool for tailored reconstruction of rheumatoid metacarpophalangeal joints.

REVISION METACARPOPHALANGEAL JOINT REPLACEMENT 30 YEARS AFTER PRIMARY SWANSON FLEXIBLE SILICONE IMPLANT ARTHROPLASTY IN A RHEUMATOID PATIENT: A CASE REPORT

Hand Surgery ◽  
2009 ◽  
Vol 14 (01) ◽  
pp. 25-29 ◽  
Author(s):  
Katsumitsu Arai ◽  
Hajime Ishikawa ◽  
Takehiro Murai ◽  
Junichi Fujisawa ◽  
Naoto Endo
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Joint Replacement ◽  
Revision Surgery ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Implant Removal ◽  
Silicone Implant ◽  
Rheumatoid Patient ◽  
Swanson Implant

We report a case of a patient with rheumatoid arthritis undergoing revision surgery 30 years after primary metacarpophalangeal joint arthroplasty using a Swanson implant. Removal and replacement of the implant were successfully performed, and the patient was satisfied with the revision surgery.

The Effect of the Additional Use of Grommets in Silicone Implant Arthroplasty of the Metacarpophalangeal Joints

1999 ◽  
Vol 24 (5) ◽  
pp. 561-564 ◽  
Author(s):  
K. SCHMIDT ◽  
R. WILLBURGER ◽  
A. OSSOWSKI ◽  
R. K. MIEHLKE
Keyword(s):  
Rheumatoid Arthritis ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Silicone Implant ◽  
Active Movement ◽  
Ulnar Deviation ◽  
Metacarpophalangeal Joints

After silicone arthroplasty of the metacarpophalangeal (MP) joint there is increasing osteolysis, subsidence and fracture of the implants in the longer postoperative term. In 44 patients with rheumatoid arthritis (54 hands) 151 arthroplasties of the metacarpophalangeal joint were assessed at a mean of 3.9 years postoperatively. In 57 arthroplasties titanium protectors (grommets) were used. There were no significant differences in the clinical outcomes with respect to swelling, correction of ulnar deviation, range of active movement and grip strength. The additional use of grommets in MP joint arthroplasty slightly reduced reactive osteolysis, protected the spacers from breakage and slightly reduced the amount of pain with only a few additional complications in the midterm follow-up.

Silicone Synovitis

1994 ◽  
Vol 19 (4) ◽  
pp. 479-484 ◽  
Author(s):  
M. LANZETTA ◽  
T. J. HERBERT ◽  
W. B. CONOLLY
Keyword(s):  
Rheumatoid Arthritis ◽  
Effective Treatment ◽  
Revision Surgery ◽  
Joint Arthroplasty ◽  
Silicone Implant ◽  
Joint Disease ◽  
Silicone Implants ◽  
True Incidence ◽  
Radiological Changes

Silicone implant arthroplasty is, arguably, the most effective treatment for the majority of patients with symptomatic arthritis in the hand and wrist. In 1985 the problem of silicone synovitis was first brought to our attention. Since that time there have been numerous reports on this condition leading to a worldwide trend against the use of silicone implants. However, the true incidence and effects of silicone synovitis have not been clearly defined. For this reason, we have undertaken a survey of all patients who have undergone silicone implant arthroplasty in the wrist and hand in our Unit between 1975 and 1990. Patients with rheumatoid arthritis and those undergoing MP or IP joint arthroplasty were excluded. Of the 289 implant arthroplasties remaining, we have been able to review personally 229 implants with a mean follow-up of 3.8 years (range 1–15). Although 40% of cases showed significant radiological changes, only 11 patients (4.8%) developed symptoms requiring treatment. Of these, two were managed conservatively whilst the rest underwent revision surgery, all with entirely satisfactory results. We conclude that silicone implant arthroplasty remains the treatment of choice for patients with painful joint disease in the hand and wrist.

Experimental Investigation of Finger Dynamics Before and After Metacarpophalangeal Joint Arthroplasty

2006 ◽  
Vol 31 (2) ◽  
pp. 228-235 ◽  
Author(s):  
Bassem Elhassan ◽  
David Mcneal ◽  
Shawn Wynn ◽  
Mark Gonzalez ◽  
Farid Amirouch
Keyword(s):  
Experimental Investigation ◽  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty ◽  
Before And After

Pyrocarbon Metacarpophalangeal Joint Arthroplasty in Noninflammatory Arthritis: Minimum 5-Year Follow-Up

2015 ◽  
Vol 40 (10) ◽  
pp. 1956-1962 ◽  
Author(s):  
David R. Dickson ◽  
Ravi Badge ◽  
David Nuttall ◽  
Adam C. Watts ◽  
Sumedh C. Talwalkar ◽  
...  
Keyword(s):  
Metacarpophalangeal Joint ◽  
Joint Arthroplasty

Proximal interphalangeal joint arthroplasty with silicone implants (NeuFlex) by a lateral approach: a series of 51 cases

2011 ◽  
Vol 37 (1) ◽  
pp. 50-55 ◽  
Author(s):  
M. Merle ◽  
F. Villani ◽  
B. Lallemand ◽  
L. Vaienti
Keyword(s):  
Lateral Approach ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Silicone Implants ◽  
Lateral Stability ◽  
Degenerative Osteoarthritis ◽  
The Mean ◽  
Quick Dash

The aim of this study is to assess outcomes of a lateral surgical approach for proximal interphalangeal joint arthroplasty with NeuFlex® silicone implants for primary degenerative osteoarthritis. We reviewed 51 arthroplasties performed on 43 patients. The mean follow up period was 36 months (range 18–42). The average preoperative range of motion (ROM) was 38°. The average postoperative ROM was 63°. In 21/51 (41%) cases, there was an average axial deviation of 17° (range 10–30°). VAS and Quick DASH scores improved. In 5/51 (10%) cases, further surgery was required. Our lateral approach seems to be effective and minimally invasive, providing adequate exposure. Contralateral incision and contralateral ligament reinforcement should be performed, whenever necessary, to improve lateral stability.

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