The Nottingham Palmar Plate Arthroplasty for Metacarpophalangeal Joint Noninflammatory Arthritis

We report the surgical technique and mid-term results of the novel Nottingham interposition arthroplasty for noninflammatory MCP joint OA. A dual dorsal and palmar incision is utilized to maximize the harvest of interposition substance. The surgical technique is described and illustrated in full. Prospective data concerning pain, range of movement and function are reported. The results of 12 arthroplasties in 9 patients are reported. At a median follow-up of 76.1 months the median arc of movement was 44 degrees, favoring an improvement in flexion. The median visual analog score for pain was 0, with all but 1 patient reporting no pain at all. Range of movement has been further improved with a progressively less restrictive rehabilitation regimen giving a median arc of 70 degrees in the more recent patients. Compared with modern implant arthroplasty techniques, the Nottingham Palmar Plate Arthroplasty has demonstrated favorable results in terms of range of movement and most importantly resolution of pain. We consider it to be a viable option in the first line management of MCP joint OA.
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research