High implant fracture incidence with sutter silicone metacarpophalangeal joint arthroplasty

We performed a retrospective review of Sutter silicone metacarpophalangeal (MP) joint arthroplasties in 34 patients (42 hands, 168 implants) with rheumatoid arthritis. Patients were evaluated at an average of 27 months (minimum follow-up period, 12 months). Twenty percent of the implants were shown to be definitely fractured on final follow-up examination, and 45% followed for more than 3 years were definitely fractured. At the final follow-up examination, the average ulnar drift in intact implants was 11° and in the fractured implants, 23°. However, there was no correlation between implant fracture and patient satisfaction. Eighty percent of patients said they would undergo the procedure again. Because of a significantly higher implant fracture incidence at a relatively shorter follow up period than that of most studies of silicone MP implants of the Swanson design, we have abandoned the use of the Sutter implant.