{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T06:03:46Z","timestamp":1780034626426,"version":"3.53.1"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T00:00:00Z","timestamp":1774051200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Metacarpophalangeal joint destruction in rheumatoid arthritis leads to pain, deformity, impaired function and poor cosmesis. Arthroplasty remains a principal reconstructive option for restoring alignment and improving function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This narrative review summarizes the current concepts of metacarpophalangeal joint arthroplasty in patients with rheumatoid arthritis. The historical evolution of surgical techniques and implant designs is outlined, with particular emphasis on flexible silicone implants, which remain the most widely used option. Indications, contraindications, implant alternatives and key aspects of surgical technique and rehabilitation are discussed. Reported clinical outcomes, complications, and long-term implant survival are reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Flexible silicone implants remain the most widely used prostheses and remain the best performing. They offer reproducible correction of ulnar drift and volar subluxation, with consistent improvements in hand alignment, function and appearance. Alternative implants, including surface-replacement and pyrocarbon prostheses, aim to replicate joint anatomy but have shown less predictable results in the rheumatoid setting, largely due to soft-tissue insufficiency. Across all implant types, outcomes are closely linked to surgical technique, particularly soft-tissue balancing, tendon realignment and management of associated deformities. Complications include recurrent deformity, limited motion, implant fracture and infection, although long-term patient satisfaction is generally high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Metacarpophalangeal joint arthroplasty continues to play a central role in the management of the rheumatoid hand. Despite advances in implant technology, flexible silicone arthroplasty provides reliable functional and cosmetic improvement in appropriately selected patients. Durable outcomes depend on reconstruction of the soft tissues, correction of associated deformities and rehabilitation, rather than implant design alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>V<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17531934261430139","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T10:04:39Z","timestamp":1774087479000},"page":"778-784","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Balancing metacarpophalangeal joint arthroplasty in rheumatoid arthritis"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-2341","authenticated-orcid":false,"given":"Daniel B","family":"Herren","sequence":"first","affiliation":[{"name":"Department of Hand Surgery, Schulthess Klinik, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,21]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198668020-00005"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-195941010-00010"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2024.03.002"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21705"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23105"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1054\/jhsb.2001.0644"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558944720926631"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hansur.2020.07.007"},{"key":"e_1_3_3_10_1","article-title":"The prosthetic replacement of rheumatoid finger joints","volume":"16","author":"Flatt AE.","year":"1960","unstructured":"Flatt AE. The prosthetic replacement of rheumatoid finger joints. Rheumatism. 1960, 16: 90\u20137.","journal-title":"Rheumatism"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jos.2023.03.013"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-830374"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2020.09.002"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2004.08.013"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(89)80045-0"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2007.09.005"},{"key":"e_1_3_3_17_1","article-title":"Functional results of excisional arthroplasty for the rheumatoid hand","volume":"108","author":"Robinson HS","year":"1973","unstructured":"Robinson HS, Kokan PJ, MacBain KP, Patterson FP. Functional results of excisional arthroplasty for the rheumatoid hand. Can Med Assoc J. 1973, 108: 1495\u20139.","journal-title":"Can Med Assoc J"},{"key":"e_1_3_3_18_1","article-title":"[Early results of NeuFlex silastic implant in MCP arthroplasty]","volume":"37","author":"Schindele S","year":"2005","unstructured":"Schindele S, Herren D, Flury M, Simmen BR. [Early results of NeuFlex silastic implant in MCP arthroplasty]. Handchir Mikrochir Plast Chir. 2005, 37: 13\u20137.","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835522500680"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-197001000-00006"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/msc.1061"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(91)90129-C"},{"key":"e_1_3_3_23_1","first-page":"47","article-title":"Finger joint replacement by silicone rubber implants and the concept of implant fixation by encapsulation","volume":"28","author":"Swanson AB.","year":"1969","unstructured":"Swanson AB. Finger joint replacement by silicone rubber implants and the concept of implant fixation by encapsulation. Ann Rheum Dis. 1969, 28(Suppl): 47\u201355.","journal-title":"Ann Rheum Dis"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0363-5023(89)90115-9"},{"key":"e_1_3_3_25_1","first-page":"1","article-title":"Results of arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis","volume":"9","author":"Vainio K","year":"1967","unstructured":"Vainio K, Reiman I, Pulkki T. Results of arthroplasty of the metacarpophalangeal joints in rheumatoid arthritis. Wiederherstellungschir Traumatol. 1967, 9: 1\u20137.","journal-title":"Wiederherstellungschir Traumatol"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2004.04.023"}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261430139","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17531934261430139","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934261430139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:48:24Z","timestamp":1780033704000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17531934261430139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,21]]},"references-count":25,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/17531934261430139"],"URL":"https:\/\/doi.org\/10.1177\/17531934261430139","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,21]]}}}