A Comparative Study of Short-Term Outcomes Between INTEGRA and AVANTA Silicone Implants for Metacarpophalangeal Joints in Patients With Rheumatoid Arthritis

IF 2.4 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2026-10-01 Epub Date: 2026-05-25 DOI:10.1016/j.jhsa.2026.04.003

Shuichi Naniwa MD, PhD, Keiichiro Nishida MD, PhD, Yoshihisa Nasu MD, PhD, Ryuichi Nakahara MD, PhD, Masahiro Horita MD, PhD, Toshifumi Ozaki MD, PhD

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引用次数: 0

Abstract

Purpose

To compare the short-term clinical outcomes and fracture rate of the silicone implants AVANTA and INTEGRA for metacarpophalangeal (MCP) joint arthroplasty in patients with rheumatoid arthritis (RA).

Methods

The current single center retrospective cohort study included consecutive RA cases who underwent MCP joint arthroplasty for the index through little fingers between August 2017 and July 2023. After exclusions, the data from 184 fingers of 58 patients (AVANTA, 96 fingers of 28 patients; INTEGRA, 88 fingers of 30 patients) were analyzed. Outcomes of MCP joint arc of motion, extension range, flexion range, ulnar deviation, grip and pinch strength, Disabilities of the Arm, Shoulder, and Hand disability/symptom (DASH d/s) score, and Hand20 score were assessed preoperatively, at 1 year, and at 2–5 years. The primary analysis was performed using mixed-effects models incorporating patient-level clustering and adjustment for baseline differences. Radiographs at each time point were reviewed for implant fracture.

Results

Both implants yielded improvements in arc of motion, extension range, flexion range, and ulnar deviation postoperatively with no significant differences. Grip strength improved in both groups, with significantly greater gains in the INTEGRA group. Pinch strength improved at 1 year in the INTEGRA group. In the INTEGRA group, DASH d/s score and Hand20 score was better than AVANTA at final follow-up. During follow-up, implant fractures occurred in 11.5% of the AVANTA group and none in the INTEGRA group, resulting in a survival rate of 77.1% for AVANTA and 100% for INTEGRA patients at 5 years after surgery.

Conclusions

Both AVANTA and INTEGRA silicone MCP arthroplasty improved arc of motion and finger alignment in patients with RA. INTEGRA showed advantages in greater grip strength, earlier pinch strength, DASH d/s score, and Hand20 score. No implant fractures were observed in the INTEGRA group during the study period.

Type of study/level of evidence

Prognosis IV.

查看原文本刊更多论文

INTEGRA硅胶植入物与AVANTA硅胶植入物治疗类风湿性关节炎患者掌指关节短期疗效的比较研究

目的：比较AVANTA硅胶假体与INTEGRA硅胶假体用于类风湿性关节炎（RA）患者掌指关节（MCP）置换术的短期临床疗效和骨折率。方法：目前的单中心回顾性队列研究包括2017年8月至2023年7月期间通过小指接受MCP关节置换术的连续RA病例。排除后，对58例患者184根手指（AVANTA， 28例96根手指；INTEGRA， 30例88根手指）的数据进行分析。术前、1年和2-5年评估MCP关节活动弧度、伸展范围、屈曲范围、尺偏度、握力和捏紧力、手臂、肩部和手部残疾/症状（DASH d/s）评分和Hand20评分。主要分析采用混合效应模型，包括患者水平聚类和基线差异调整。每个时间点的x线片检查假体骨折。结果：两种植入物术后在活动弧度、伸展范围、屈曲范围和尺侧偏差方面均有改善，无显著差异。两组的握力都有所提高，其中INTEGRA组的效果更明显。INTEGRA组1年夹紧强度提高。最后随访时，INTEGRA组DASH d/s评分和Hand20评分均优于AVANTA组。随访期间，11.5%的AVANTA组患者发生假体骨折，而INTEGRA组患者没有发生假体骨折，术后5年AVANTA组和INTEGRA组患者的生存率分别为77.1%和100%。结论：AVANTA和INTEGRA硅胶MCP关节置换术均可改善RA患者的活动弧度和手指对齐。INTEGRA在握力大、握力早、DASH d/s评分、Hand20评分等方面表现出优势。INTEGRA组在研究期间未观察到种植体骨折。研究类型/证据水平：预后IV。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.