Kay A G, Jeffs J V, Scott J T
Ann Rheum Dis. 1978 Jun;37(3):255-8. doi: 10.1136/ard.37.3.255.
Nine patients with rheumatoid arthritis, who had Silastic prostheses (Swanson's) introduced into 34 metacarpophalangeal joints, were reviewed 5 years after surgery. The most important long-term advantage conferred by the introduction of prostheses was pain relief; functional benefit was marginal. The majority of prostheses eventually fractured but this did not necessarily lead to a functional deterioration. Impairment of function was usually the result of loss of flexion at the metacarpophalangeal joints, but it was sometimes due to excessive instability after fracture of the prostheses. It is suggested that Silastic joint replacement may be a worthwhile procedure in rheumatoid patients with moderate destruction or deformity of the metacarpophalangeal joints when pain is a predominant feature. Significant functional improvement can be anticipated only when secondary to pain relief.
对9例类风湿性关节炎患者进行了回顾性研究，这些患者在34个掌指关节中植入了硅橡胶假体（斯旺森型），术后5年进行复查。植入假体带来的最重要的长期益处是缓解疼痛；功能改善有限。大多数假体最终发生骨折，但这不一定会导致功能恶化。功能障碍通常是掌指关节屈曲丧失的结果，但有时是假体骨折后过度不稳定所致。建议对于掌指关节有中度破坏或畸形且疼痛为主要特征的类风湿患者，硅橡胶关节置换可能是一种值得尝试的手术。只有在疼痛缓解后，才能预期有显著的功能改善。
