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Metacarpophalangeal joint arthroplasty

40 citationsUpdated Aug 2026

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Overview

Metacarpophalangeal joint arthroplasty continues to play a central role in the management of the rheumatoid hand [1]. The indications for and long-term expectations of silicone metacarpophalangeal arthroplasty must be carefully examined in light of improvements in the medical management of rheumatoid disease [2]. Patients report satisfaction with only modest gains in grip and pinch strength after silicone metacarpophalangeal arthroplasty [5]. Swanson silicone arthroplasty frequently results in a range of flexion of the metacarpophalangeal joint of the little finger that may be insufficient for its principal functions [6]. Larger, prospective series are needed to prove superior longevity and functional outcomes of thumb silastic metacarpophalangeal arthroplasty versus fusion [13].

Pyrolytic carbon metacarpophalangeal arthroplasty has not seen the high rate of complications associated with proximal interphalangeal joint pyrolytic carbon arthroplasty [3]. HAPY spherical pyrocarbon interposition arthroplasty for the metacarpophalangeal joint demonstrates satisfactory short- to mid-term outcomes, with considerable improvements in pain relief and joint mobility [4]. Metacarpophalangeal arthroplasty using a pyrocarbon implant for osteoarthritis demonstrates a 7% revision rate at 5 years after surgery [8]. Metacarpophalangeal arthroplasty with a pyrocarbon implant demonstrated reliable improvement in pain and arc of motion in patients with rheumatoid arthritis [9]. Caution is advised in lifting heavy weights after pyrocarbon metacarpophalangeal joint arthroplasty, especially if there is radiographic evidence of loosening, due to the risk of implant fracture [10].

Metacarpophalangeal surface replacement arthroplasty for noninflammatory arthritis can improve arc of motion and pain, though 1 in 3 joints requires reoperation [11].

Anatomy & Pathophysiology

Osseous and Implant Considerations

Pyrolytic Carbon Implants: Pyrolytic carbon MCP arthroplasty does not exhibit the high complication rate seen in proximal interphalangeal joint pyrolytic carbon arthroplasty [3].

Silicone Implants: Silicone MCP arthroplasty provides only modest gains in grip and pinch strength [5]. Swanson silicone arthroplasty frequently results in a range of flexion of the little finger MP joint that may be insufficient for its principal functions [6]. Increasing MCP joint flexion range is associated with increased fractures of silicone implants in patients with rheumatoid arthritis [22]. Implant fractures following silicone MCP joint arthroplasty in rheumatoid arthritis do not significantly affect upper limb function [27]. Patients with greater hand function preoperatively may be at higher risk of revision surgery after silicone MCP joint arthroplasty for inflammatory arthritis [21]. Revision MCP joint surgery in rheumatoid patients following previous silicone arthroplasty yields generally poor objective results, including minimal improvement in ulnar drift, a high rate of implant fracture, and no change in arc of motion [33].

Bioreconstructive Implants: Bioreconstructive poly-L/D-lactide implants and Swanson prostheses provide comparable improvement in clinical assessments, except for better maintenance of palmar alignment in the Swanson group [16]. NeuFlex and Swanson implants both provide satisfactory clinical improvement after MCP reconstruction of the hand in rheumatoid arthritis [14].

Ligamentous and Soft Tissue Reconstruction

Thumb MCP Joint: Thumb MCP joint capsulodesis performed concurrently with trapeziometacarpal arthroplasty produces positive results [12]. Implant-free anatomical reconstruction of thumb MCP joint chronic ulnar collateral ligament injuries achieves stable intra-osseous fixation and restores grip, pinch strength, and range of motion while avoiding drawbacks associated with implants [30]. A surgical strategy for severely collapsed zigzag thumb deformities involves gradual correction with external fixators following arthroplasty for osteoarthritis of the thumb carpometacarpal joint [15].

MCP Hyperextension and Deformity: Not all MCP hyperextension deformities associated with trapeziometacarpal osteoarthritis require surgical intervention following trapeziectomy with ligament reconstruction and tendon interposition arthroplasty [32]. Secondary outcomes including key pinch strength, pain, the brief Michigan Hand Outcomes Questionnaire, and complications do not differ between groups at 2 years following correction of MCP joint hyperextension after trapeziometacarpal joint implant arthroplasty [18]. Ulnar fingers do not necessarily have worse outcomes than radial fingers after silicone arthroplasty; sufficient correction of deformities in ulnar fingers is possible with adequate bone resection and realignment of the extensor mechanism [28].

Kinematics and Postoperative Mechanics

MCP joint arthroplasty in the setting of trauma preserves adequate MCP joint motion and results in little pain [7]. Volar and proximal translation of the proximal phalanx is observed on 4-dimensional computed tomography after silicone implant arthroplasty in patients with rheumatoid arthritis [29].

Classification

Silicone Arthroplasty: Metacarpophalangeal joint arthroplasty continues to play a central role in the management of the rheumatoid hand [1]. Indications for and long-term expectations of silicone metacarpophalangeal arthroplasty must be carefully examined in light of improvements in the medical management of rheumatoid disease [2]. Swanson silicone arthroplasty frequently results in a range of flexion of the metacarpophalangeal joint of the little finger that may be insufficient for its principal functions [6]. Both NeuFlex and Swanson metacarpophalangeal implants obtained satisfactory clinical improvement after metacarpophalangeal reconstruction of the hand in patients with rheumatoid arthritis [14]. Improvement in clinical assessments was comparable between bioreconstructive poly-L/D-lactide implants and Swanson prostheses, except for better maintenance of palmar alignment in the Swanson group [16]. Crossed intrinsic transfer does not significantly affect the outcome of silastic interposition arthroplasty of the metacarpophalangeal joints in rheumatoid patients [38].

Pyrolytic Carbon Arthroplasty: The high rate of complications seen in proximal interphalangeal joint pyrolytic carbon arthroplasty has not been seen for pyrolytic carbon metacarpophalangeal joint arthroplasty [3]. HAPY spherical pyrocarbon interposition arthroplasty for the metacarpophalangeal joint demonstrates satisfactory short- to mid-term outcomes, with considerable improvements in pain relief and joint mobility [4]. Metacarpophalangeal arthroplasty using a pyrocarbon implant for osteoarthritis demonstrates a 7% revision rate at 5 years after surgery [8]. Metacarpophalangeal arthroplasty with a pyrocarbon implant demonstrated reliable improvement in pain and arc of motion in patients with rheumatoid arthritis [9]. Caution is advised in lifting heavy weights after pyrocarbon metacarpophalangeal joint arthroplasty, especially if there is radiographic evidence of loosening [10].

Surface Replacement Arthroplasty: Metacarpophalangeal surface replacement arthroplasty for noninflammatory arthritis can improve arc of motion and pain, though 1 in 3 joints requires reoperation [11].

Trauma-Related Arthroplasty: Metacarpophalangeal joint arthroplasty in the setting of trauma results in preservation of adequate joint motion and little pain [7].

Other Considerations: Periprosthetic joint infection is uncommon after metacarpophalangeal or proximal interphalangeal arthroplasties [17].

Clinical Presentation

Metacarpophalangeal joint arthroplasty plays a central role in the management of the rheumatoid hand [1]. Indications for and long-term expectations of silicone metacarpophalangeal arthroplasty must be examined in light of improvements in the medical management of rheumatoid disease [2]. Patients report satisfaction with only modest gains in grip and pinch strength after silicone metacarpophalangeal arthroplasty [5]. Silastic interposition arthroplasty of the metacarpophalangeal joint is reliable in terms of pain relief and correction of deformity, with high patient satisfaction despite only modest improvements in the objective assessment of hand function [25]. Metacarpophalangeal joint arthroplasty is an effective treatment option from a patient-centered perspective, improving appearance, pain, and function [20].

Most patients who did not undergo secondary revision surgery after metacarpophalangeal arthroplasty experienced improvements in pain and range of motion [19]. Metacarpophalangeal arthroplasty with a pyrocarbon implant demonstrates reliable improvement in pain and arc of motion in patients with rheumatoid arthritis [9]. Larger, prospective series are needed to prove superior longevity and functional outcomes of thumb silastic metacarpophalangeal arthroplasty versus fusion [13].

Patients undergoing metacarpophalangeal joint arthroplasty in the setting of trauma experience preservation of adequate joint motion and little pain [7]. A convex pyrocarbon metacarpophalangeal joint prosthesis successfully restored longitudinal stability and forearm length in a patient with congenital radial head dislocation and a deformed concave capitellum, resulting in significant pain relief and functional improvement at 5 years [24]. Pyrocarbon implant fracture is an unusual cause for early revision, with caution advised in lifting heavy weights especially if there is radiographic evidence of loosening [10].

Investigations

Plain radiography: Standard imaging is essential for pre-operative planning and post-operative assessment. In cases of congenital radial head dislocation with a deformed concave capitellum, radiographs help identify the need for a convex pyrocarbon metacarpophalangeal joint prosthesis to restore longitudinal stability and forearm length [24]. For noninflammatory arthritis, plain films assist in selecting patients for metacarpophalangeal surface replacement arthroplasty (SRA), which improves arc of motion and pain but carries a reoperation rate of 1 in 3 joints [11]. In the setting of trauma, radiographs help confirm adequate MCP joint motion and low pain levels post-arthroplasty [7]. When post-traumatic bone loss or postinfectious dysfunction require surgical intervention, imaging guides the decision between resection arthroplasty and arthrodesis [26].

MRI: No specific MRI findings or indications are provided in the current evidence base for metacarpophalangeal joint arthroplasty investigations.

CT: No specific CT findings or indications are provided in the current evidence base for metacarpophalangeal joint arthroplasty investigations.

Bone scan: No specific bone scan findings or indications are provided in the current evidence base for metacarpophalangeal joint arthroplasty investigations.

Tomosynthesis: No specific tomosynthesis findings or indications are provided in the current evidence base for metacarpophalangeal joint arthroplasty investigations.

Aspiration: Periprosthetic joint infection (PJI) is uncommon after MCP or PIP arthroplasties, suggesting aspiration is not routinely indicated for routine follow-up unless clinical suspicion arises [17].

Laboratory: No specific laboratory markers or indications are provided in the current evidence base for metacarpophalangeal joint arthroplasty investigations.

Other Considerations: Clinical outcomes vary by implant type and pathology. Pyrolytic carbon MCP arthroplasty has not demonstrated the high complication rates seen in proximal interphalangeal joint pyrolytic carbon arthroplasty [3]. In rheumatoid arthritis, both NeuFlex and Swanson metacarpophalangeal implants provide satisfactory clinical improvement [14], while pyrocarbon implants offer reliable improvement in pain and arc of motion [9]. Bioreconstructive poly-L/D-Lactide implants show comparable clinical improvement to Swanson prostheses, though Swanson implants better maintain palmar alignment [16]. Patients report satisfaction with only modest gains in grip and pinch strength after silicone metacarpophalangeal arthroplasty [5]. Dorsal capsule interposition arthroplasty is a viable option for isolated degenerative or traumatic arthritis of the MCPJ, with an average follow-up of 2 years [23]. Thumb MCP joint capsulodesis performed concurrently with trapeziometacarpal arthroplasty is a straightforward procedure producing positive results [12]. Secondary outcomes, including key pinch strength, pain, the brief Michigan Hand Outcomes Questionnaire, and complications, did not differ between groups at 2 years following correction of metacarpophalangeal joint hyperextension after trapeziometacarpal joint implant arthroplasty [18].

Treatment

Non-Operative

The provided evidence does not contain specific data on conservative management options such as weight loss, physical therapy, NSAIDs, or injections.

Operative

Implant Selection: Silicone metacarpophalangeal arthroplasty is an effective treatment option from a patient-centered perspective, improving appearance, pain, and function [20]. Swanson silicone arthroplasty is recommended as the implant of choice for metacarpophalangeal joint arthroplasty despite a high fracture rate, as fractures do not translate into clinical failures [37]. Both NeuFlex and Swanson metacarpophalangeal implants provide satisfactory clinical improvement after metacarpophalangeal reconstruction of the hand in patients with rheumatoid arthritis [14].

Pyrolytic Carbon Implants: Pyrolytic carbon metacarpophalangeal arthroplasty does not exhibit the high rate of complications seen in proximal interphalangeal joint pyrolytic carbon arthroplasty [3]. Pyrocarbon metacarpophalangeal arthroplasty for osteoarthritis demonstrates a 7% revision rate at 5 years after surgery [8]. Metacarpophalangeal arthroplasty using a pyrocarbon implant for osteoarthritis provides good pain relief, a functional range of motion, and high satisfaction in the majority of patients [36]. Caution is advised when lifting heavy weights after pyrocarbon metacarpophalangeal joint arthroplasty, especially if there is radiographic evidence of loosening, due to the risk of implant fracture [10].

Other Considerations: Larger, prospective series are needed to prove superior longevity and functional outcomes of thumb silastic arthroplasty versus fusion [13]. Dorsal capsule interposition arthroplasty provides a viable surgical option for isolated degenerative or traumatic arthritis of the metacarpophalangeal joint at an average follow-up of 2 years [23]. Thumb metacarpophalangeal joint capsulodesis performed concurrently with trapeziometacarpal arthroplasty can be a straightforward procedure that produces positive results [12].

Complications

Periprosthetic fracture: Intraoperative periprosthetic fractures occur in 3% of metacarpophalangeal joint arthroplasties and are associated with pyrocarbon implants, cementless fixation, and diabetes mellitus [42]. Pyrocarbon implant fracture is an unusual cause for early revision in metacarpophalangeal joint arthroplasty [10].

Infection (PJI): Periprosthetic joint infection is uncommon after primary metacarpophalangeal or proximal interphalangeal arthroplasty [17].

Other Considerations: Silicone metacarpophalangeal arthroplasty results in only modest gains in grip and pinch strength [5]. Swanson silicone arthroplasty frequently results in a range of flexion of the little finger metacarpophalangeal joint that may be insufficient for its principal functions [6]. Metacarpophalangeal surface replacement arthroplasty for noninflammatory arthritis requires reoperation in 1 in 3 joints [11]. Metacarpophalangeal arthroplasty using a pyrocarbon implant for osteoarthritis has a 7% revision rate at 5 years [8]. Most patients who did not undergo secondary revision surgery for metacarpophalangeal arthroplasty experienced improvements in pain and range of motion [19].

Recovery

Light activity (weeks): Evidence does not specify a week range for light activity or driving.

Full activity (months): Evidence does not specify a month range for full activity or strength return.

Complete recovery / outcome plateau (months): Evidence does not specify a month range for outcome plateau.

Rehabilitation protocol: Specific rehabilitation protocols, including PT phasing, immobilisation duration, or brace removal timing, are not detailed in the provided evidence.

Functional milestones: Silastic interposition arthroplasty of the metacarpophalangeal joint is reliable for pain relief and deformity correction, yielding high patient satisfaction despite only modest improvements in objective assessments of hand function [25]. Follow-up studies indicate that metacarpophalangeal joint arthroplasty in rheumatoid arthritis improves function and deformity, achieving nearly uniform patient satisfaction [41]. In rheumatoid patients, clinical assessment improvements were comparable between bioreconstructive poly-L/D-lactide implants and Swanson prostheses, except for better maintenance of palmar alignment in the Swanson group [16]. However, Swanson arthroplasty frequently results in a range of flexion in the little finger that may be insufficient for its principal functions [6]. Patients undergoing arthroplasty in the setting of trauma preserved adequate joint motion and experienced little pain [7].

Other Considerations: Patient expectations of metacarpophalangeal joint arthroplasty are uniformly high, with functional improvement being the greatest motivation for surgery [31]. Joint goal-setting is essential for understanding patients' unique reasons for undergoing arthroplasty and facilitating realistic expectations [34]. Patients with greater hand function preoperatively may be at higher risk of revision surgery after silicone metacarpophalangeal joint arthroplasty for inflammatory arthritis [21]. Increasing metacarpophalangeal joint flexion range is associated with increased fractures of silicone implants [22]. Crossed intrinsic transfer may reduce the recurrence of ulnar drift after metacarpophalangeal joint silastic arthroplasty at a mean follow-up of 50 months, but there was no functional difference between the two groups [35]. A surgical strategy for severely collapsed zigzag thumb deformities involves gradual correction with external fixators following metacarpophalangeal joint arthroplasty for osteoarthritis of the thumb carpometacarpal joint [15].

Key Evidence

  • [L5] Metacarpophalangeal joint arthroplasty continues to play a central role in the management of the rheumatoid hand. [1] (10.1177/17531934261430139)
  • [L4] Given these findings, the indications for and long-term expectations of silicone metacarpophalangeal arthroplasty must be carefully examined in light of the improvements in the medical management of rheumatoid disease. [2] (10.2106/00004623-200310000-00001)
  • [L5] This high rate of complications seen in proximal interphalangeal joint pyrolytic carbon arthroplasty has not been seen for pyrolytic carbon MCP arthroplasty. [3] (10.1016/j.jhsa.2012.11.025)
  • [L4] The HAPY spherical pyrocarbon interposition arthroplasty for the metacarpophalangeal joint demonstrates satisfactory short- to mid-term outcomes, with considerable improvements in pain relief and joint mobility. [4] (10.1016/j.jhsg.2025.100804)
  • [L2] Patients were satisfied with only modest gains in grip and pinch strength after silicone metacarpophalangeal arthroplasty. [5] (10.1016/j.jhsa.2011.09.042)
  • [L4] Our experience with this cohort, a review of published literature, and a survey of international experts suggest that Swanson arthroplasty frequently results in a range of flexion of the MP joint of the little finger that may be insufficient for its principal functions. [6] (10.1007/s11552-007-9051-5)
  • [L4] Patients had preservation of adequate MCP joint motion and experienced little pain. [7] (10.1016/j.jhsa.2015.09.012)
  • [L4] Metacarpophalangeal arthroplasty using a pyrocarbon implant for osteoarthritis demonstrates a 7% revision rate at 5 years after surgery. [8] (10.1016/j.jhsa.2022.08.013)
  • [L4] Metacarpophalangeal arthroplasty with a pyrocarbon implant demonstrated reliable improvement in pain and arc of motion in patients with RA. [9] (10.1177/15589447211063577)
  • [L4] Though the pyrocarbon implant is successful in metacarpophalangeal joint arthroplasty, caution is advised in lifting heavy weights especially if there is radiographic evidence of loosening. [10] (10.1177/1753193409341105)
  • [L4] Metacarpophalangeal SRA for noninflammatory arthritis can improve arc of motion and pain, though 1 in 3 joints requires reoperation. [11] (10.1177/15589447211028917)
  • [L4] Thumb MCP joint capsulodesis performed concurrently with trapeziometacarpal arthroplasty can be a straightforward procedure that produces positive results. [12] (10.1016/j.jhsa.2014.07.045)
  • [L4] Larger, prospective series are needed to prove superior longevity and functional outcomes of thumb SMPA versus fusion. [13] (10.1177/1558944719878841)
  • [L1] Both implant groups obtained satisfactory clinical improvement after MCP reconstruction of the hand. [14] (10.1016/j.jhsa.2009.09.020)
  • [Paper] The study proposes a surgical strategy for severely collapsed zigzag thumb deformities using gradual correction with external fixators. [15] (10.1007/s12593-015-0178-2)
  • [L1] Improvement in clinical assessments was comparable in both groups, except for better maintenance of palmar alignment in the Swanson group. [16] (10.1177/1753193410375777)
  • [L4] PJI is uncommon after MCP or PIP arthroplasties. [17] (10.1016/j.jhsa.2024.12.008)
  • [L3] Secondary outcomes including key pinch strength, pain, the brief Michigan Hand Outcomes Questionnaire and complications did not differ between groups at 2 years. [18] (10.1177/17531934251330975)
  • [L4] However, most patients who did not undergo a secondary revision surgery experienced improvements in pain and range of motion. [19] (10.5435/jaaos-d-17-00042)
  • [L4] MCP joint arthroplasty is an effective treatment option from a patient-centered perspective, improving appearance, pain, and function. [20] (10.1016/j.hcl.2006.02.001)
  • [L3] Patients with greater hand function preoperatively may be at higher risk of revision surgery. [21] (10.1177/1558944719831236)
  • [L4] Increasing MCP joint flexion range was associated with increased fractures of the implants. [22] (10.1016/j.jhsa.2020.09.002)
  • [L4] This technique of dorsal capsule interposition arthroplasty provides a viable surgical option for isolated degenerative or traumatic arthritis of the MCPJ at an average follow-up of 2 years. [23] (10.1177/1558944720911215)
  • [L4] The use of a convex pyrocarbon metacarpophalangeal joint prosthesis successfully restored longitudinal stability and forearm length in a patient with congenital radial head dislocation and a deformed concave capitellum, resulting in significant pain relief and functional improvement at 5 years. [24] (10.1016/j.jse.2014.08.004)
  • [L4] Silastic interposition arthroplasty of the MCPJ is reliable in terms of pain relief and correction of deformity, and patient satisfaction is high despite only modest improvements in the objective assessment of hand function. [25] (10.1054/jhsb.2000.0402)
  • [L5] When post-traumatic bone loss or postinfectious dysfunction require surgical intervention, the hand surgeon may need to consider resection arthroplasty and arthrodesis. [26] (10.1016/j.hcl.2006.02.011)
  • [L4] However, implant fractures did not significantly affect upper limb function. [27] (10.1016/j.jhsa.2024.01.009)
  • [L2] The hypothesis that ulnar fingers would have worse outcomes than radial fingers was not proven; sufficient correction of deformities in ulnar fingers is possible if adequate bone resection and realigning of the extensor mechanism are carefully performed. [28] (10.1016/j.jhsa.2009.06.029)
  • [L4] Volar and proximal translation of the proximal phalange was observed on 4-dimensional computed tomography. [29] (10.1016/j.jhsa.2021.10.001)
  • [L4] The surgical procedure achieved stable intra-osseous fixation and restored grip, pinch strength, and range of motion while avoiding drawbacks associated with implants. [30] (10.1177/17531934231182895)
  • [L1] Patient expectations of MCP joint arthroplasty were uniformly high, with functional improvement being the greatest motivation for surgery. [31] (10.1016/j.jhsa.2011.02.002)
  • [L4] Not all MCP hyperextension deformities will require surgical interventions according to known algorithms. [32] (10.1007/s00402-021-03838-8)
  • [L4] Objective results, however, were generally poor, with minimal improvement in ulnar drift, a high rate of implant fracture, and no change in arc of motion. [33] (10.1016/j.jhsa.2007.07.026)
  • [L4] Joint goal-setting is essential for understanding patients' unique reasons for undergoing MCP arthroplasty and facilitating realistic expectations. [34] (10.1002/msc.1061)
  • [L3] Crossed intrinsic transfer may reduce the recurrence of ulnar drift after metacarpophalangeal joint silastic arthroplasty at a mean follow up of 50 months, but there was no functional difference between the two groups. [35] (10.1054/jhsb.2001.0644)
  • [L4] Good pain relief, a functional range of motion, and high satisfaction were seen in the majority of patients. [36] (10.1016/j.jhsa.2015.06.104)
  • [L5] The authors recommend Swanson silicone arthroplasty as the implant of choice for MP joint arthroplasty despite a high fracture rate, as fractures do not translate into clinical failures. [37] (10.1016/j.hcl.2006.02.010)
  • [L2] Crossed intrinsic transfer does not significantly affect the outcome of Silastic interposition arthroplasty of the metacarpophalangeal joints in rheumatoid patients. [38] (10.1054/jhsb.2001.0574)
  • [L5] Follow-up studies show that this surgery improves function and deformity and achieves nearly uniform patient satisfaction. [41] (10.5435/00124635-200305000-00005)
  • [L3] Intraoperative fractures occurred in 3% of MCP joint arthroplasties and were associated with pyrocarbon implants, cementless fixation, and diabetes mellitus. [42] (10.1016/j.jhsa.2014.12.038)

See Also

References

[1] Balancing metacarpophalangeal joint arthroplasty in rheumatoid arthritis. Journal of Hand Surgery (European Volume). 2026. DOI: 10.1177/17531934261430139

[2] METACARPOPHALANGEAL JOINT ARTHROPLASTY IN RHEUMATOID ARTHRITIS. The Journal of Bone and Joint Surgery-American Volume. 2003. DOI: 10.2106/00004623-200310000-00001

[3] Clinical and Radiographic Outcomes of Metacarpophalangeal Joint Pyrolytic Carbon Arthroplasty for Osteoarthritis. The Journal of Hand Surgery. 2013. DOI: 10.1016/j.jhsa.2012.11.025

[4] Functional Outcomes of Spherical Pyrocarbon HAPY Metacarpophalangeal Interposition Arthroplasty for Long Fingers: A Retrospective Study of 16 Cases. Journal of Hand Surgery Global Online. 2025. DOI: 10.1016/j.jhsg.2025.100804

[5] Objective Functional Outcomes and Patient Satisfaction After Silicone Metacarpophalangeal Arthroplasty for Rheumatoid Arthritis. The Journal of Hand Surgery. 2012. DOI: 10.1016/j.jhsa.2011.09.042

[6] Insufficient Flexion of the Metacarpophalangeal Joint of the Little Finger Following Swanson Silicone Arthroplasty for Rheumatoid Arthritis. HAND. 2007. DOI: 10.1007/s11552-007-9051-5

[7] Metacarpophalangeal Joint Arthroplasty in the Setting of Trauma. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.09.012

[8] Metacarpophalangeal Joint Pyrocarbon Arthroplasty for Osteoarthritis: An Analysis of 44 Arthroplasties. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2022.08.013

[9] Outcomes of Pyrocarbon Arthroplasty in Metacarpophalangeal Joints Affected by Rheumatoid Arthritis. HAND. 2022. DOI: 10.1177/15589447211063577

[10] Pyrocarbon implant fracture after metacarpophalangeal joint arthroplasty: an unusual cause for early revision. Journal of Hand Surgery (European Volume). 2010. DOI: 10.1177/1753193409341105

[11] Outcomes of Surface Replacement Arthroplasty in Metacarpophalangeal Joints Affected by Noninflammatory Arthritis. HAND. 2021. DOI: 10.1177/15589447211028917

[12] Volar Capsulodesis of the Thumb Metacarpophalangeal Joint at the Time of Basal Joint Arthroplasty: A Surgical Technique Using Suture Anchors. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.07.045

[13] Long-term Outcomes of Silastic Arthroplasty of the Thumb Metacarpophalangeal Joint. HAND. 2019. DOI: 10.1177/1558944719878841

[14] NeuFlex and Swanson Metacarpophalangeal Implants for Rheumatoid Arthritis: Prospective Randomized, Controlled Clinical Trial. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2009.09.020

[15] Correction of a Hyperextension Deformity at the Metacarpophalangeal Joint by Arthroplasty for Osteoarthritis of the Thumb Carpometacarpal Joint Followed by External Fixator: A Case Series. Journal of Hand and Microsurgery. 2015. DOI: 10.1007/s12593-015-0178-2

[16] Bioreconstructive Poly-L/D-Lactide Implant Compared With Swanson Prosthesis in Metacarpophalangeal Joint Arthroplasty in Rheumatoid Patients: a Randomized Clinical Trial. Journal of Hand Surgery (European Volume). 2010. DOI: 10.1177/1753193410375777

[17] Incidence and Presentation of Periprosthetic Joint Infection After Primary Metacarpophalangeal and Proximal Interphalangeal Arthroplasty. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.12.008

[18] Correction of metacarpophalangeal joint hyperextension following trapeziometacarpal joint implant arthroplasty: a case–control study. Journal of Hand Surgery (European Volume). 2025. DOI: 10.1177/17531934251330975

[19] Revision Metacarpophalangeal Arthroplasty: A Longitudinal Study of 128 Cases. Journal of the American Academy of Orthopaedic Surgeons. 2019. DOI: 10.5435/jaaos-d-17-00042

[20] Rheumatoid Arthritis: Silicone Metacarpophalangeal Joint Arthroplasty Indications, Technique, and Outcomes. Hand Clinics. 2006. DOI: 10.1016/j.hcl.2006.02.001

[21] Factors Associated With Reoperation After Silicone Metacarpophalangeal Joint Arthroplasty in Patients With Inflammatory Arthritis. HAND. 2019. DOI: 10.1177/1558944719831236

[22] Risk Factors Contributing to Early Implant Fracture in Silicone Metacarpophalangeal Joint Arthroplasty for Patients With Rheumatoid Arthritis. The Journal of Hand Surgery. 2021. DOI: 10.1016/j.jhsa.2020.09.002

[23] Dorsal Capsule Interpositional Arthroplasty of the Metacarpophalangeal Joint. HAND. 2020. DOI: 10.1177/1558944720911215

[24] Unique application of a metacarpophalangeal joint implant as a radial head prosthesis. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2014.08.004

[25] Outcome Measures Following Metacarpophalangeal Joint Replacement. Journal of Hand Surgery. 2000. DOI: 10.1054/jhsb.2000.0402

[26] Finger Metacarpophalangeal Joint Disease: The Role of Resection Arthroplasty and Arthrodesis. Hand Clinics. 2006. DOI: 10.1016/j.hcl.2006.02.011

[27] Long-Term Implant Fracture Rates Following Silicone Metacarpophalangeal Joint Arthroplasty in Rheumatoid Arthritis. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.01.009

[28] Outcomes of Silicone Arthroplasty for Rheumatoid Metacarpophalangeal Joints Stratified by Fingers. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.06.029

[29] In Vivo Metacarpophalangeal Joint Kinematics After Silicone Implant Arthroplasty in Patients With Rheumatoid Arthritis. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2021.10.001

[30] Implant-free anatomical reconstruction of thumb metacarpophalangeal joint chronic ulnar collateral ligament injuries. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231182895

[31] Hand Appearance as a Patient Motivation for Surgery and a Determinant of Satisfaction with Metacarpophalangeal Joint Arthroplasty for Rheumatoid Arthritis. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.02.002

[32] Does trapeziectomy with ligament reconstruction and tendon interposition arthroplasty correct the metacarpophalangeal joint hyperextension associated with trapeziometacarpal osteoarthritis?. Archives of Orthopaedic and Trauma Surgery. 2021. DOI: 10.1007/s00402-021-03838-8

[33] Results of Revision Metacarpophalangeal Joint Surgery in Rheumatoid Patients Following Previous Silicone Arthroplasty. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2007.07.026

[34] Patients' Expectations, Experiences and the Determinants of Satisfaction related to Metacarpophalangeal Arthroplasty. Musculoskeletal Care. 2013. DOI: 10.1002/msc.1061

[35] The Value of Crossed Intrinsic Transfer after Metacarpophalangeal Silastic Arthroplasty: A Comparative Study. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2001.0644

[36] Pyrocarbon Metacarpophalangeal Joint Arthroplasty in Noninflammatory Arthritis: Minimum 5-Year Follow-Up. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2015.06.104

[37] Thumb Metacarpophalangeal Arthritis: Arthroplasty or Fusion?. Hand Clinics. 2006. DOI: 10.1016/j.hcl.2006.02.010

[38] A Comparison of Metacarpophalangeal Joint Silastic Arthroplasty with or Without Crossed Intrinsic Transfer. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2001.0574

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