A 10-Year Follow-Up of Uncemented Constrained Metacarpophalangeal Joint Arthroplasties Using the RM Prosthesis in a Patient with Rheumatoid Arthritis.

A 72-year-old male with high-demand activities of daily living presented with rheumatoid arthritis mostly affected finger joints of his right hand. Radiographically, there was severe destruction with luxation of metacarpophalangeal joints (MCPJs) II-V. The constrained RM prostheses were inserted into the MCPJs II-V typically in the uncemented manner, and the course was primarily complicated due to periprosthetic fracture of the metacarpal IV intraoperatively, that was treated with immobilization in a plaster splint for 6 weeks. After that, the course was uncomplicated. Eight years after primary surgery, the patient reported increasing pain with loss of function isolated in his MCPJ IV since 6 months; all other finger joints did not reveal any clinically relevant symptoms. Radiographically, distinctive osteolyses with cortical thinning around all components of the 4 RM prostheses were seen, and the hinge joint of implant in MCPJ IV was broken. A total exchange arthroplasty of the MCPJ IV using the unconstrained MCPJ resurfacing SRTM MCP implant with cementation of both components was performed. At the 10-year follow-up, that includes a 2-year followup after MCPJ IV exchange arthroplasty, there was unchanged correct positioning of all MCPJ implants; and despite distinctive radiographic loosening and subsidence of the 3 other RM prostheses, the patient is able to perform his high-demand activities of daily living. Key words: Rheumatoid arthritis; Metacarpophalangeal joint; Constrained arthroplasty; Resurfacing arthroplast