Patient outcomes following Swanson silastic metacarpophalangeal joint arthroplasty in the rheumatoid hand: a systematic overview.

OBJECTIVE

To investigate the effectiveness of Swanson silastic metacarpophalangeal joint arthroplasty (SMPA) in improving hand function for patients with rheumatoid arthritis.

METHODS

A systematic overview of all published series in the literature on SMPA from 1966 to 1999.

RESULTS

Research design deficiencies were quite prevalent in the literature on SMPA. However, SMPA was effective in correcting ulnar drift and in improving the arc of motion of the fingers. Health related quality of life was improved in the domains of hand function, pain, activities of daily living, aesthetics, and satisfaction.

CONCLUSION

SMPA appeared to be an effective procedure in correcting rheumatoid hand deformities. Future research must establish objective, quantifiable measures of hand function improvement by using standardized hand function tests and validated hand outcome questionnaires.