Custom-Fashioned Antibiotic Impregnated PMMA MCP Joint Arthroplasty in the Acute Setting Long-term Outcome: A Novel Technique Revisited: Our Own Experience

Description

This presentation discusses the intricate management of osteomyelitis and septic arthritis in the hand, particularly focusing on a case involving an 81-year-old male patient with severe rheumatoid arthritis. The speaker, Eleni Hadjikyriakou, outlines the conventional treatment approaches, such as antibiotics and surgical debridement, and highlights the potential complications including functional deficits and joint stiffness. A notable procedure described is the use of a single-stage custom-made arthroplasty using methylmethacrylate spacers, which was successfully implemented in the case presented, resulting in the preservation of the patient's premorbid hand function.



Eleni describes the surgical process in detail, including the importance of adequate debridement and the shaping of the cement spacer used to replace the compromised joint. The patient showed remarkable recovery with no recurrence of infection and regained good range of motion, demonstrating a 10 to 90 degree functional capability of the MCP joint one year post-operation.



The discussion includes reflections on the outcome, emphasizing that the treatment was initially seen as a last-ditch effort to salvage the patient's finger. Eleni concludes that this innovative approach, while not widely reported in existing literature, proved effective for this low-demand patient, allowing for an indefinite reconstruction. The presentation concludes with recognition of the audience's engagement and acknowledges the collaboration with co-speaker Frances Bowerman.

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