Arthroplasty for severe deforming arthropathy in overlap syndrome of systemic lupus erythematosus and anti-Jo-1 antibody positive dermatomyositis

AbstractWe experienced a rare case of severe contracturedand flexed metacarpophalangeal joint(MPJ) arthropathyin a patient with overlap syndromeof systemic lupus erythematosus and dermatomyositis. The patient was a 60-year-old female with high anti-nuclear antibodyand anti-Jo-1 antibody titerswhose hands had gradually deformed without arthralgia during the past 6 years. Both hands were extremely contractured; in particular, the right hand had dislocations of the second to fifth MPJs, ankyloses of some proximal interphalangeal and distal interphalangeal joints, and z-shaped deformity of the thumb. We performed thumbarthroplasty and artificial jointreplacement of the second to fifth MPJs of the dominant right hand. These operations enabled improvement of the patient’s ability to perform daily activities, with an improvement from 1.125 to 0.625 of the Japanese version of the Stanford Health AssessmentQuestionnaire score. Although surgery to treat contractureddeformities can only partially recover t...