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Interphalangeal joint replacement

Marta Favero, Giorgio Perino, Maria Luisa Valente, Cesare Tiengo, Roberta Ramonda
The aim of this study was to describe the histological features of erosive hand osteoarthritis (EHOA), which is considered an aggressive subset of hand osteoarthritis (OA) characterized by severe local inflammation and degeneration of the distal and proximal interphalangeal joints. Two patients with EHOA underwent replacement with a cement-free press fit ceramic prosthesis of a proximal interphalangeal joint (PIPJ). Clinical and radiological data were collected and histological examination was performed. Radiological examination with histological correlation showed complete erosion of the articular cartilage with focal presence of peripheral fibrocartilaginous resurfacing, sclerosis, and remodeling of the exposed bone, osteoclastic activity with resorptive lacunae in the subchondral bone and around degenerative fibromyxoid pseudocysts, coarse trabeculation of the cancellous bone, and marginal osteophytes...
January 4, 2017: Skeletal Radiology
Musa Ugur Mermerkaya, Houman Adli
PURPOSE: We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). PATIENTS AND METHODS: From 2012 to 2014, all data from patients who underwent surgery for the treatment of grades 2-3 HR were retrospectively reviewed, and 45 patients were included in this study. Of these patients, 26 underwent metatarsal head-resurfacing hemiarthroplasty (Group I) and 19 underwent TJR (Group II)...
2016: Clinical Interventions in Aging
S F Schindele, A Altwegg, S Hensler
OBJECTIVE OF SURGERY: The cementless implantation of the surface replacement CapFlex-PIP enables pain relief, preservation of motion, improves lateral stability and corrects axis deviation in proximal interphalangeal (PIP) joints of patients with primary and secondary PIP osteoarthritis. INDICATIONS: Painful PIP joints as a result of degenerative or posttraumatic osteoarthritis with restriction of motion. Secondary inflammatory destruction of PIP joints in rheumatoid arthritis with low inflammatory activity and good bone conditions...
February 2017: Operative Orthopädie und Traumatologie
Ken Shirakawa, Masahiko Shirota
BACKGROUND: Postoperative contracture as a major complication of surface replacement arthroplasty (SRA) remains an unresolved problem. Contracture after SRA can occur early in the postoperative period due to mechanical dysfunction, and tardy contracture where ROM declines with time postoperatively is also reported. METHODS: 13 fingers with degenerative osteoarthritis and two fingers with post-traumatic arthritis where SRA was performed using volar approach were involved...
October 2016: Journal of Hand Surgery Asian-Pacific Volume
J Gülke, M Mentzel, D Dornacher, L Schneider, T Kapapa, N J Wachter
BACKGROUND/PURPOSE: Joint replacement is a widely used procedure to treat painful osteoarthritis of the proximal interphalangeal joint. From 1996 to 1999, 16 patients received 19 hinged, piston-based DIGITOS prostheses in our department. In 2007, the 7-year clinical course of 14 patients (17 devices) was published in this journal. Now 12 of these patients (15 devices) have been followed with an average history of 17 years, and the preoperative data has been compared with the results after 7 and 17 years, respectively...
August 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Stephan F Schindele, Christoph M Sprecher, Stefan Milz, Stefanie Hensler
INTRODUCTION: Primary press fit and secondary osteointegration is a precondition for component anchoring in articular surface replacements, also in the case of proximal interphalangeal (PIP) joint. Nevertheless, many existing prostheses for the PIP joint have failed to show sufficient osteointegration. CapFlex-PIP(©) implant is a modular metal-polyethylene surface replacement for the PIP joint consisting of a proximal and distal component each having a titanium pore backside, which allows secondary osteointegration at the bone-implant interface...
September 2016: Archives of Orthopaedic and Trauma Surgery
Keiichiro Nishida
The number of cases with rheumatoid arthritis who requires arthroscopic synovectomy is declining, but it is still a useful procedure in combination with effective pharmacologic disease control. For the destruction of glenohumeral joint, total shoulder arthroplasty is effective for pain relief and functional outcome for patients without rotator cuff impairment. The reverse shoulder arthroplasty has been shown favorable short-term results, but need a careful indication for rheumatoid shoulder with poor bone stock and bone quality...
June 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Nai-Jen Chang, Johnny T Chang, Chung-Chen Hsu, Cheng-Hung Lin, Chih-Hung Lin, Yu-Te Lin
BACKGROUND: In cases of mutilating hand injuries, the primary goal is recovery of prehensile function. This is particularly true in the case of joints, which are extremely difficult to replace or reconstruct adequately when damaged. Heterotopic vascularized joint transfer is indicated when salvageable joints are available for transfer to a more functionally optimal position on the hand. MATERIALS AND METHODS: Seven cases of mutilating hand injuries treated with heterotopic vascularized joint transfers from 2003 to 2012 were retrospectively identified...
March 2016: Annals of Plastic Surgery
Hui Lu, Hui Shen, Qiang Chen, Xiang-Qian Shen, Shou-Cheng Wu
The current study presents the case of a 25-year-old male who developed tumor recurrence of the proximal phalange of the ring finger on the right hand 4 years after partial tumor resection surgery. An X-ray of the right hand showed that the distal bone of the proximal phalange on the ring finger was destroyed. An artificial finger joint replacement was performed using a silicone joint for this unusual tumor recurrence. The pathological findings were indicative of a giant cell tumor of the tendon sheath. As a result of surgery, the patient's proximal interphalangeal point motion recovered to the pre-operative level...
December 2015: Oncology Letters
O Flannery, O Harley, R Badge, A Birch, D Nuttall, I A Trail
The MatOrtho proximal interphalangeal replacement is a cementless cobalt-chromium metal-on-polyethylene mobile-bearing surface replacement arthroplasty. The aim of this study is to report the outcome and complications of this implant at a minimum of 2 years follow-up from a single institution. A retrospective case review was performed on all MatOrtho proximal interphalangeal joint replacements performed with a minimum of 2 years follow-up. Patient demographics, diagnosis, implant revision and other surgical interventions were recorded...
November 2016: Journal of Hand Surgery, European Volume
Gregory I Bain, Duncan T McGuire, Aleksandra M McGrath
Proximal interphalangeal joint replacement is an effective treatment for painful arthritis affecting the joint. However, the complication rate is relatively high, with many of these complications related to soft-tissue imbalance or instability. Volar, dorsal, and lateral approaches have all been described with varying results. We describe a new simplified lateral hinge approach that splits the collateral ligament to provide adequate exposure of the joint. Following insertion of the prosthesis the collateral ligament is simply repaired, side-to-side, which stabilizes the joint...
September 2015: Techniques in Hand & Upper Extremity Surgery
Andrew Naylor, Martin C Bone, Anthony Unsworth, Sumedh C Talwalkar, Ian A Trail, Thomas J Joyce
Clinical results of the PyroCarbon proximal interphalangeal joint replacement are inconsistent with various complications reported. To address this, in vitro testing was conducted using finger joint simulators. Two PyroCarbon proximal interphalangeal prostheses were tested in a lubricant of dilute bovine serum to 5 × 10(6) cycles of flexion-extension (90°-30°) with dynamic forces of 10 N applied. At intervals of 3000 cycles testing ceased and a static load of 100 N was applied to simulate gripping...
May 2015: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Charles D Jennings, Douglas P Livingstone
PURPOSE: To evaluate the long-term results of proximal interphalangeal (PIP) joint surface replacement arthroplasty for arthritis using the SR PIP implant (Small Bone Innovations, New York, NY). METHODS: This is a long-term retrospective analysis of results in 39 of 43 joints first reported in 2008. Subjective results were based upon a mailed questionnaire. Active range of motion was measured by a certified hand therapist, and x-rays were obtained to analyze changes occurring since the first study...
March 2015: Journal of Hand Surgery
Maarten Van Nuffel, Ilse Degreef, Sofie Willems, Luc De Smet
Prosthetic replacement of the proximal interphalangeal joints is an operative treatment for osteoarhtritis, to preserve the range of motion and the function of the hand. The purpose of this study is to detect the differences regarding pain and function between a silicone implant using a volar approach and a resurfacing implant, placed through a dorsal approach. Patients were reviewed clinically and scored. We found no significant differences in outcome between the two types of implants. However, the complication rate in the resurfacing group was significantly higher...
June 2014: Acta Orthopaedica Belgica
L Natera, E Moya-Gómez, C Lamas-Gómez e l, I Proubasta
INTRODUCTION: Arthropathy of the proximal interphalangeal (PIP) joint symptoms is very restrictive, and in some cases arthroplasty is required. In most of the reported series of PIP silicone arthroplasty, the technique described is the dorsal approach. As far as we know, the role of the volar approach in PIP arthroplasty has still not been adequately assessed. OBJECTIVES: To retrospectively review the patients who had PIP joint arthroplasty, and to study the clinical and radiographic outcomes in relation to the approach: volar or dorsal...
September 2014: Revista Española de Cirugía Ortopédica y Traumatología
Shinsuke Shigematsu, Hiroyuki Shimizu, Moroe Beppu, Kazuaki Hirata
This study aimed to determine whether the extensor pollicis longus (EPL) or abductor pollicis longus (APL) can replace the function of thumb extension in hands in which the extensor pollicis brevis (EPB) is absent. Cadaver dissection was performed to examine anatomical association between the interphalangeal (IP) joint and metacarpophalangeal (MP) joint of the thumb, as well as extension mechanism in clinical cases. EPB insertion could be classified into eight types, and the EPB was absent in 7.6% of all cases...
2014: Hand Surgery
Valerie H Tan, Arul Murugan, Tun-Lin Foo, Mark E Puhaindran
Venous anastomosis in distal fingertip replantations is not always possible, and venous congestion is recognized as a potential cause of failure. Methods previously described to address this problem include amputate deepithelization and dermal pocketing postarterial anastomosis to augment venous outflow. However, attachment of the digit to the palm or abdomen resulted in finger stiffness. We describe a modification of the previous methods by utilizing dermal flaps raised from the adjacent digit in the form of a cross-finger flap...
September 2014: Techniques in Hand & Upper Extremity Surgery
Ignacio R Proubasta, Claudia G Lamas, Luis Natera, Angelica Millan
PURPOSE: To evaluate the short-term clinical and radiographic outcome of a silicone proximal interphalangeal (PIP) joint implant using a volar approach in patients with primary osteoarthritis. METHODS: We retrospectively reviewed 36 proximal PIP joints that were replaced with Avanta silicone implants in 26 patients. Inclusion criteria were diagnosis of primary osteoarthrtitis of the PIP joint and failure to respond to conservative treatment. Clinical asessment included range of motion, patient satisfaction, and pain scores...
June 2014: Journal of Hand Surgery
T Pillukat, M Mühldorfer-Fodor, M Schädel-Höpfner, J Windolf, K-J Prommersberger
BACKGROUND: Injuries of the proximal interphalangeal joint (PIP joint) are common. They are frequently underestimated by patients and initial treating physicians, leading to unfavorable outcomes. Basic treatment includes meticulous clinical and radiological diagnosis as well as anatomical and biomechanical knowledge of the PIP joint. TREATMENT: In avulsions of the collateral ligaments and the palmar plate with or without involvement of bone, nonoperative treatment is preferred...
April 2014: Der Unfallchirurg
Aravind Desai, Fraser J Gould, David C Mackay
Pyrocarbon arthroplasty of the proximal interphalangeal joint (PIPJ) has been reported to provide excellent pain relief when treating osteoarthritis of the hand. We retrospectively reviewed 20 PIPJ arthroplasties performed on 14 patients by a single surgeon using Ascension prosthesis. The mean follow up period was 3.5 years (range 1-7 years). Excellent pain relief was noted at the final follows-up. The mean range of motion improved from 40° pre-operatively to 70° post-operatively which was statistically significant...
2014: Hand Surgery
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