Srnec Jason J, Wagner Eric R, Rizzo Marco
Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN.
Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN.
J Hand Surg Am. 2017 Oct;42(10):817-825. doi: 10.1016/j.jhsa.2017.07.030. Epub 2017 Aug 30.
Arthritis of the hand can result from inflammatory arthritis, osteoarthritis (OA), or be posttraumatic and can cause pain and debilitation. Arthroplasty serves as 1 surgical option in the surgical management of arthritis and aims to create a pain-free joint with preservation of motion. Although implant arthroplasty of the proximal interphalangeal (PIP), metacarpophalangeal (MCP), and trapeziometacarpal (TMC) joints predictably produce pain relief and high satisfaction, it has historically suffered from high rates of complications. The hinged silicone prosthesis was 1 of the early implants and, in many cases, remains the gold standard. However, problems with deformity correction, implant fracture, and synovitis remain. Implants made of alternative materials such as metal-plastic and pyrocarbon have evolved; however, survivorship and reoperation rates remain a concern. This review details the evolution and current options available for small joint implant arthroplasty involving the MCP, PIP, and TMC joints.
手部关节炎可由炎性关节炎、骨关节炎（OA）引起，也可能是创伤后所致，会导致疼痛和功能障碍。关节成形术是关节炎外科治疗中的一种手术选择，旨在创建一个无痛且能保留活动度的关节。尽管近端指间关节（PIP）、掌指关节（MCP）和大多角骨掌骨关节（TMC）的植入式关节成形术可预期地缓解疼痛并带来较高满意度，但历来并发症发生率较高。铰链式硅胶假体是早期的植入物之一，在许多情况下仍是金标准。然而，在畸形矫正、植入物骨折和滑膜炎方面仍存在问题。由金属塑料和热解碳等替代材料制成的植入物不断发展；然而，生存率和再次手术率仍是令人担忧的问题。本综述详细介绍了涉及MCP、PIP和TMC关节的小关节植入式关节成形术的发展历程及当前可用的选择。
