Resection arthroplasty is the definitive treatment for end stage metacarpophalangeal (MCP) joint pathology in the rheumatoid hand. MCP joint replacement reduces pain and ulnar drift, increases range of motion, and improves cosmesis (Kirschenbaum et al. 1993). Ideally, MCP replacements should restore normal finger joint mechanics. Implant center of rotation should approximate that of the intact joint to balance the flexor and extensor tendon forces (Beevers et al, 1995). In addition, implant pistoning should be minimized to reduce bone erosion and the release of particulate wear debris that can lead to silicone synovitis (Beevers et al, 1995).
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