New concepts in arthroplasty of the hand and wrist.

Clinical trials with cemented polyethyiene and metal total joint arthroplasties were initiated in 1973. Replacements have been developed for the wrist, carpometacarpal joint of the thumb, metacarpophalangeal joints of the thumb and fingers, and the proximal interphalangeal joints of the fingers. Results, evaluated by pain relief and joint stability, were excellent at all sites. Motion, however, averaged only 50% of normal. Significant problems included abnormal posture in the wrist, roentgenographic evidence of loosening in the finger metacarpophalangeals, extensor lag in the metacarpophalangeal of the thumb, and lack of motion in the proximal interphalangeal joint of the finger.