In RA, hand surgery improves function, appearance

(HealthDay)—Treating rheumatoid arthritis (RA) patients with severe hand deformities with a silicone metacarpophalangeal joint arthroplasty (SMPA) procedure produces significant, long-term improvement in hand function and appearance, according to research published in the September issue of Arthritis Care & Research.

Kevin C. Chung, M.D., of the University of Michigan Health System in Ann Arbor, and colleagues conducted a multicenter prospective cohort study involving 67 surgical and 95 nonsurgical RA patients with poor baseline functioning due to severe hand deformities to evaluate the efficacy and durability of response with the SMPA procedure.

The researchers found that, at baseline, surgical patients had worse Michigan Hand Outcomes Questionnaire (MHQ) function and functional measurements. Compared with the nonsurgical group, patients in the surgical group had significant improvements in their overall scores on the MHQ score and MHQ function, activities of daily living, aesthetics, and satisfaction section scores at three years. Significant improvement was also noted in ulnar deviation, extensor lag, and arc of motion in the metacarpophalangeal and proximal interphalangeal joints of surgical versus nonsurgical patients. Minimal complications were observed, with a fracture rate of 9.5 percent.

"The most important outcome for rheumatoid patients and hand surgeons considering surgery is improved function," the authors write. "Our three-year results have demonstrated that the SMPA procedure will improve function and activities of daily living and restore the appearance of severely deformed rheumatoid hands."