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

We experienced a rare case of severe contractured and flexed metacarpophalangeal joint (MPJ) arthropathy in a patient with overlap syndrome of systemic lupus erythematosus and dermatomyositis. The patient was a 60-year-old female with high anti-nuclear antibody and anti-Jo-1 antibody titers whose 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 thumb arthroplasty and artificial joint replacement 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 Assessment Questionnaire score. Although surgery to treat contractured deformities can only partially recover the functional ability, it also has indications for arthroplasties.