**5. Conclusion**

This review suggests that *all* regimens contribute toward an increase in MCP motion and an increase in hand function, but despite the efforts of patients and clinicians, hand therapists remain unaware of the most effective postoperative protocol for MCP arthroplasty or the suitability of each regimen for specific implants and soft-tissue

[14] Harada Y, Okumura S and Takahashi Y. Hand Therapy After Metacarpophalangeal

[15] Chung KC, Kotsis SV, and Kim HM, A Prospective Outcomes Study of Swanson

Pettersson K, Wagnsjo P, Hulin E. NeuFlex compared with Sutterprostheses: a blind,

[16] V.A. Nuñez and N.D. Citron. Short-term results of the Ascension™ pyrolytic

[17] Rettig LA, Luca L and Murphy MS. Silicone Implant Arthroplasty in Patients With

[18] Moller K, Sollerman C, Geijer M, Kopylov P, Ta¨gil M.Avanta versus Swanson silicone

[19] Parkkila T , Belt EA, Markku Hakala M, Kautiainen H and Leppilahti J. Comparison of

[20] Thomsen NOB, Michel E. H. Boeckstyns MEH and Leth-Espensen P. Value of

[21] Radmer S, Andresen S and Sparmann M. Poor experience with a hinged endoprosthesis

[22] Ishikawa H, Murasawa A, Hanyu T (2002). The effects of activity andtype of

[24] Sambandam SN Analysis of methodological deficiencies of studies reporting surgical

[25] Zhao C, Amadio PC, Zobitz ME, Momose T, Couvreur P, An K-N. Effect of synergistic

[26] Tang JB, Wang B, Chen F, Chen Zhong Pan, Xie RG. Biomechanical evaluation of flexor

tendon repair techniques. Clin Orthop. 2001;386:252-9.

metacarpophalangeal joint. Journal of Hand Surgery, 27B (2):180–183. [23] Stothard J, Thompson AE and Sherris D. Correction of ulnar drift during silastic

prostheses. Scand J Plastic Reconstr Surg 2006;40:284 –290.

followed for 2 years. J Hand Surg 2005;/30B:/8-13.

Surgery Volume 30, Issue 6, 2005, Pages 1276-1281

the thumb. Int Orthop 2007 31:639-45.

2010Volume 23, Issue 4, Pages e2-e3.

Am. 2004 July; 29(4): 646–653.

164.

2005;30A:667–672.

2003; 37: 113–116

2002;396:223-30.

590.

65.

Joint Implant Arthroplasty in Rheumatoid Hand. Journal of Hand Therapy

Metacarpophalangeal Joint Arthroplasty for the Rheumatoid Hand. J Hand Surg

prospective, randomized comparison of Silastic metacarpophalangeal joint

carbon metacarpophalangeal Joint replacement arthroplasty for osteoarthritis. Chirurgie de la Main. Volume 24, Issues 3-4, June-August 2005, Pages 161-

Idiopathic Osteoarthritis of the Metacarpophalangeal Joint J Hand Surg

implants in the MCP joint -a prospective, randomized comparison of 30 patients

Swanson and Sutter Metacarpophalangeal Arthroplasties in Patients With Rheumatoid Arthritis: A Prospective and Randomized Trial Journal of Hand

dynamic splinting after replacement of the metacarpophalangeal joint in patients with rheumatoid arthritis. Scand J Plast Reconstr Surg Hand Surg

(WEKO) for the metacarpophalangeal joints. *Acta Orthop Scand* 2003; 74 (5): 586–

rheumatoid arthritis on the flexible implant arthroplasty ofthe

metacarpophalangeal joint arthroplasty. J Hand Surg (British Volume) 16B: 61-

outcome following cemented total-joint arthroplasty of trapezio-metacarpal joint of

motion on flexor digitorum profundus tendon excursion. Clin Orthop.

procedures. Difficulties in researching this topic include low patient numbers, highly variable preoperative status, lack of guidelines for outcome measures and time frames, and the effects of subsequent interventions received by the patient. The nature and size of the population with rheumatoid arthritis and MCP arthroplasty do not readily fit the randomized, controlled trial design. Paired sample designs are suggested, as well as the formation of standard outcome measures, for better comparison of results between patients.

### **6. References**


procedures. Difficulties in researching this topic include low patient numbers, highly variable preoperative status, lack of guidelines for outcome measures and time frames, and the effects of subsequent interventions received by the patient. The nature and size of the population with rheumatoid arthritis and MCP arthroplasty do not readily fit the randomized, controlled trial design. Paired sample designs are suggested, as well as the formation of standard outcome measures, for better comparison of results between

[1] Krishnan J. The Biomechanical and Anatomical Basis for the Design of a New MCP Joint

[2] Beevers DJ, Seedhom BB. Metacarpophalangeal joint prostheses. J Hand Surg.

[3] Swanson AB. Silicone rubber implants for replacement of arthritic or destroyed joints in

[4] Beiber EJ, Weiland AJ, Violenec-Dowling S. Silicone-rubber implant arthroplasty of the

[5] Pereira JA, Belcher HJCR. A comparison of metacarpophalangeal joint silastic

[6] Madden JW, De Vore G, Arem AJ. A rational post-operative program for

[7] Clarke M, Oxman AD (eds). Cochrane Reviewers' Handbook 4.1.4. Oxford: The

[8] Ring D, Simmons BP, Hayes M. Continuous passive motion following metacarpophalangeal joint arthroplasty. J Hand Surg. 1998;23A:505–11. [9] Thomsen NOB, Boeckstyns MEH and Leth-Espensen P. Value of dynamic splinting after

[10] Groth G, Watkins M, Paynter P. Effect of an alternative flexion splinting protocol on

[11] Burr N, Pratt AL, Smith PJ. An alternative splinting and rehabilitation protocol for

[12] Burr N, Pratt AL. MCP joint arthroplasty case study: the Mount Vernon static regime.

[13] Escott B, Ronald K and Judd M. NeuFlex and Swanson Metacarpophalangeal Implants

Journal of Hand Surgery Volume 35, Issue 1, 2010, Pages 44-51.

arthritis. Scand J Plast Reconstr Surg Hand Surg 2003; 37: 113–116.

the hand. Surg Clin North Am. 1972;48:1113-27.

Cochrane Library, issue 4, update software, 2001.

mid-joint ROM [letter]. J Hand Ther. 1996;9:68-9.

Hand Ther. 2002;15:41-7.

Br J Hand Ther. 1999;4:137-40.

Prosthesis: [doctoral thesis], Australia: Flinders University School of Biomedical

metacarpophalangeal joints for rheumatoid arthritis. J Bone Joint Surg [Am].

arthroplasty with or without crossed intrinsic transfer. J Hand Surg. 2001;26B:229-

metacarpophalangeal joint implant arthroplasty. J Hand Surg. 1977;2A:358-

replacement of the Metacarpophalangeal joint in patients with rheumatoid

metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis. J

for Rheumatoid Arthritis: Prospective Randomized, Controlled Clinical Trial

patients.

**6. References** 

Engineering, 1998.

1995;20B:125-36.

1986;68:206-9.

34.

66.


**Humeral Hemiarthroplasty with Spherical Glenoid Reaming: Theory and Technique** 

Despite improvements in glenoid prosthesis design, materials and surgical techniques, complications related to the glenoid component continue to be a leading cause of failure after total shoulder arthroplasty. Although previously felt to be of little clinical significance, radiolucent lines around the glenoid prosthesis are now recognized as a sign of impending mid and long term fixation problems. While much attention in shoulder prosthesis design has focused on anatomical reconstruction of the humerus through increasing modularity, comparatively little progress has been made in solving the problems of glenoid wear and fixation failure. Resolving these issues on the socket side of the equation remains a challenge for the shoulder arthroplasty surgeon as the population ages, as young patients present with terminal shoulder arthritis and as patients demand higher performance from their implant.

Fig. 1. In the normal glenohumeral joint, the compliance of the articular cartilage and the labrum provide for conforming surfaces which optimize stability and load distribution.

**1. Introduction** 

 **of The Ream and Run Procedure** 

*Seacoast Orthopedics and Sports Medicine* 

Moby Parsons

*Somersworth, NH* 

*USA* 

[27] Tugwell P, Boers M. OMERACT conference on outcome measures in rheumatoid arthritis clinical trials: conclusion. J Rheumatol. 1993;20:590-1. **27** 
