Functional results of excisional arthroplasty for the rheumatoid hand.

Two types of assessment were used in our evaluation of the long-term results of excisional MCP arthroplasty in the rheumatoid hand: a standard surgeon-patient assessment, and a functional test model applied to 17 rheumatoid hands before and after operation.The surgeon-patient overall assessment at the time of follow-up indicated satisfaction with the results in 15 of 17 hands, whereas the occupational therapists' objective functional testing indicated a less positive end result - improvement in 6 of the 17 hands and worsening in 8.The discrepancy need not negate the validity of either finding but would suggest that factors other than function as measured give patient satisfaction. These include such features as pain relief, ability to put on gloves again and improved appearance.