Vranis Neil M, Marascalchi Bryan, Melamed Eitan
Hansjorg Wyss Department of Plastic and Reconstructive Surgery, NYU Langone Health, New York, NY, USA.
Department of Orthopedic Surgery, NYU Langone Health, New York, NY, USA.
J Hand Surg Asian Pac Vol. 2020 Mar;25(1):39-46. doi: 10.1142/S2424835520500058.
Arthritis can have profound debilitating effects on the hand secondary to finger deformities and pain. Arthroplasty of the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) can be performed to reduce pain while maintaining joint range of motion. We used outpatient surgery registries from the states of California and Florida to assess the trends of arthroplasty across several recent years and to determine if the outcomes differ based on disease etiology. We found that there has been a steady decline in number of MCP arthroplasty procedures performed annually between 2005 and 2011 while PIP arthroplasty procedures peaked in 2007 and have since also declined. There was an overall complication rate of 2.4% and no difference in cardiac, respiratory, deep venous thrombosis and infection between patients with osteoarthritis and other arthritic etiologies. However, the risk of device failure in patients with rheumatoid arthritis is found to be significantly higher than for patients with osteoarthritis ( < 0.01). PIP and MCP arthroplasty are safe procedures with an overall low complication rate. The increased risk of device related complications observed in patients with rheumatoid arthritis can be used to appropriately counsel this patient population regarding post-operative expectations and prognosis.
关节炎可因手指畸形和疼痛对手部产生严重的致残影响。可进行掌指关节（MCP）和近端指间关节（PIP）置换术以减轻疼痛，同时保持关节活动范围。我们利用加利福尼亚州和佛罗里达州的门诊手术登记数据，评估近年来关节置换术的趋势，并确定结果是否因疾病病因不同而有所差异。我们发现，2005年至2011年间，每年进行的MCP置换术数量稳步下降，而PIP置换术在2007年达到峰值，此后也有所下降。总体并发症发生率为2.4%，骨关节炎患者与其他关节炎病因患者在心脏、呼吸、深静脉血栓形成和感染方面无差异。然而，发现类风湿关节炎患者的器械故障风险显著高于骨关节炎患者（<0.01）。PIP和MCP置换术是安全的手术，总体并发症发生率较低。类风湿关节炎患者中观察到的与器械相关并发症风险增加，可用于就此患者群体的术后预期和预后进行适当的咨询。
