Goldfarb Charles A, Dovan Thomas T
Department of Orthopaedic Surgery, Washington University School of Medicine at Barnes-Jewish Hospital, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110, USA.
Hand Clin. 2006 May;22(2):177-82. doi: 10.1016/j.hcl.2006.02.001.
Silicone implant arthroplasty has been used for more than 40 years for severe rheumatoid disease at the metacarpophalangeal (MCP) joint. Multiple investigations have shown that silicone arthroplasty places the MCP joint in a more extended posture, with some improvement in the total arc of motion. Ulnar drift is also improved, but strength and other objective measures have not demonstrated marked changes postoperatively. The lack of prospective data and more complete outcome assessment has been, at least in part, responsible for the marked difference in opinions between rheumatologists and hand surgeons on the effectiveness of MCP arthroplasty. Recent reports using patient-centered outcome measures have shown that early outcome is favorable, with improvements in appearance, pain, and function.
硅胶植入关节成形术已用于治疗掌指（MCP）关节严重类风湿疾病40多年。多项研究表明，硅胶关节成形术可使MCP关节处于更伸展的姿势，总活动弧度有所改善。尺侧偏移也有所改善，但术后力量和其他客观指标并未显示出明显变化。前瞻性数据的缺乏以及更全面的结果评估至少在一定程度上导致了风湿病学家和手外科医生在MCP关节成形术有效性问题上的显著意见分歧。最近使用以患者为中心的结果指标的报告显示，早期结果良好，外观、疼痛和功能均有所改善。
