Metacarpophalangeal Joint Arthroplasty in Patients With Systemic Lupus Erythematosus: Outcomes and Challenges

Purpose Metacarpophalangeal joint (MCP) arthroplasty is a surgical intervention for patients with systemic lupus erythematosus (SLE) and deformities unresponsive to nonsurgical treatments. This study aims to assess the functional outcomes and complication profile of MCP arthroplasty in patients with SLE. Methods A retrospective study was conducted of patients with SLE who underwent MCP arthroplasty between 2003 and 2019. Clinical data, including demographics, operative indications, complications, and outcomes, were reviewed. Follow-up data were collected through chart reviews and phone interviews. Patient-reported outcome measures, obtained during telephone follow-up, included pain assessed using the visual analog scale, upper-extremity function using the Disabilities of the Arm, Shoulder, and Hand, and hand appearance satisfaction using the HandQ questionnaire. Results Thirteen patients with SLE (mean age, 61.92 years) underwent 55 MCP arthroplasties. The main indications for surgery were pain and deformity refractory to nonsurgical treatment. The median follow-up duration was 89.15 months (range, 6.1–259.3 months). After surgery, seven patients had extended follow-up. Complications included eight prosthesis fractures, one infection, and five recurrent deformities. Pain relief was modest (visual analog scale, 2.7/10), functional outcomes were moderate (Disabilities of the Arm, Shoulder, and Hand 47.4), and hand appearance satisfaction was low (HandQ 31/100). Conclusions MCP arthroplasty in patients with SLE provides moderate, long-term functional improvement and pain relief. However, patient satisfaction with hand appearance remains low. Given the small cohort size and SLE's heterogeneity, further research is needed to optimize long-term outcomes. Level of evidence/type of study Therapeutic IV, Retrospective Case Series.