ABSTRACT
Among the many prostheses that have been developed since the 1960s (Egloff 2000), only one has stood the test of time so far, and remains the gold standard for metacarpophalangeal (MP) joint arthroplasty, more than 30 years after being introduced by Alfred Swanson (Swanson 1968, Swanson and de Groot Swanson 1984): the onepiece silicone implant. This flexible hinge prosthesis acts as a spacer and produces local encapsulation. Although it has drawbacks, related mainly to a limited range of motion, and a risk of fracture over the long term, its overall results in rheumatoid patients are still more satisfactory than two-piece prostheses. The latter, whether constrained or not, have had many problems including instability, recurrence of the deformity, bone fracture or erosion, cement loosening, and contracture.
