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Proximal interphalangeal joint arthroplasty

Patrick K Y Goon, Kalpesh R Vaghela, Shirley Stougie, Jan H Coert
The hemi-hamate arthroplasty for proximal interphalangeal joint (PIPJ) dorsal fracture dislocations relies on complete dislocation of the joint using the 'shotgun' approach which provides excellent exposure but damages the delicate intrinsic joint stabilisers. We present a new approach to the PIPJ when performing the hemi-hamate arthroplasty. The volar surgical approach involves freeing up the whole tendon sheath-periosteal unit as a single layer, and retracting this to one side. The articular surface of the joint can then be accessed with a little distraction and hyperextension...
June 2018: Journal of Hand Surgery Asian-Pacific Volume
Nicole Forster, Stephan Schindele, Laurent Audigé, Miriam Marks
This systematic review and meta-analysis investigates the prevalence of complications, reoperations (surgeries without implant modifications) and revisions (surgeries with implant modifications) after proximal interphalangeal joint arthroplasty with pyrocarbon, metal-polyethylene and silicone implants. Thirty-four articles investigating 1868 proximal interphalangeal joints were included. Implant-related complications were associated with 14%, 10% and 11% of the pyrocarbon, metal-polyethylene and silicone implants, respectively, yet these rates were not significantly different from one another...
January 1, 2018: Journal of Hand Surgery, European Volume
Charles P Melone, Erez Dayan
Hallmark deformities of systemic scleroderma are early onset and progressively disabling flexion contractures of the proximal interphalangeal (PIP) joints often in conjunction with extension or, less frequently, flexion contractures of the metacarpophalangeal (MCP) joints. Although surgical correction is generally recommended, a prevailing reluctance for operative treatment exists owing to the inherent ischemia of the disease with its potentially compromised healing capacity. Nonetheless, with recognition and preservation of the tenuous but well-defined and constant periarticular vascular networks of the PIP and MCP joints, articular reconstruction with uncomplicated wound healing can prove consistently successful for patients with scleroderma...
April 9, 2018: Journal of Hand Surgery
Chelsea A Harris, Melissa J Shauver, Frank Yuan, Jacob Nasser, Kevin C Chung
PURPOSE: We sought to compare preferences for arthroplasty versus arthrodesis among patients with proximal interphalangeal (PIP) joint osteoarthritis (OA) by quantifying the patient-assigned utility of each operation's attributes. METHODS: We undertook a multistep process to identify relevant surgical attributes, including a literature review, surgeon survey, and pretest patient pilot test to build a set of discrete choice experiments. Patients with PIP joint osteoarthritis were identified using a single university electronic medical record and were recruited via electronic message or postcard...
April 5, 2018: Journal of Hand Surgery
Francis J Aversano, Ryan P Calfee
Salvaging a failed proximal interphalangeal (PIP) joint implant arthroplasty remains a considerable technical and rehabilitation challenge. Experienced arthroplasty surgeons have reported 70% survival of revision PIP implants at 10 years with 25% of patients requiring subsequent revision surgery. At this time, there is no consensus surgical approach or implant proven superior for revision implant arthroplasty of the PIP joint. Secondary arthrodesis or amputation may be required to salvage the failed PIP implant arthroplasty with compromised bone stock or soft tissue envelopes that are inadequate for implant arthroplasty...
May 2018: Hand Clinics
Ryan D Katz, James P Higgins
Microvascular toe interphalangeal joint transfer can serve as a means of autogenous digit proximal interphalangeal joint (PIPJ) arthroplasty. Among surgical options for treating dysfunctional, absent, or destroyed PIPJs, free toe joint transfer is the most technically challenging and carries the greatest donor site cost to patients. Despite drawbacks, free toe joint transfer is a valuable tool with considerable advantages over conventional arthroplasty in the appropriate clinical setting. Particular advantages include lifelong durability, coronal plane stability, low infection risk, and growth potential in skeletally immature patients...
May 2018: Hand Clinics
Michiro Yamamoto, Kevin C Chung
This review analyzes various surgical exposures and implant designs for proximal interphalangeal (PIP) joint pathology. Our literature review found that silicone implants using a volar approach had the best arc of motion, least extension lag, and lowest complication rates compared with all the other implant designs and approaches. Surface replacement arthroplasties had more frequent surgical revisions compared with silicone implants. Continued efforts toward the development of improved PIP joint implants are necessary...
May 2018: Hand Clinics
Andy F Zhu, Paymon Rahgozar, Kevin C Chung
Proximal interphalangeal (PIP) joint arthritis is a debilitating condition. The complexity of the joint makes management particularly challenging. Treatment of PIP arthritis requires an understanding of the biomechanics of the joint. PIP joint arthroplasty is one treatment option that has evolved over time. Advances in biomaterials have improved and expanded arthroplasty design. This article reviews biomechanics and arthroplasty design of the PIP joint.
May 2018: Hand Clinics
Nima Naghshineh, Kanu Goyal, Juan M Giugale, Mithun K Neral, Joel V Ferreira, Glenn A Buterbaugh, Joseph E Imbriglia
BACKGROUND: Osteoarthritis of the proximal interphalangeal (PIP) joint affects a large percentage of the population and can lead to significant functional disability. The purpose of this study is to evaluate the midterm clinical effectiveness of PIP joint arthroplasty for nonrheumatic arthritis. METHODS: A single-center retrospective cohort study evaluating preoperative and postoperative objective and subjective measures was conducted. Range of motion (ROM), Disabilities of the Arm, Shoulder and Hand scores, key pinch strength, grip strength, and satisfaction with respect to pain, deformity, function, and strength were measured...
April 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Jason J Srnec, Eric R Wagner, Marco Rizzo
We retrospectively reviewed and compared the outcomes and complications associated with 81 single digit and 168 multi-digit proximal interphalangeal joint arthroplasties performed from 1998 to 2012 in 136 patients. Clinical outcomes were assessed with an average follow-up of 5.3 years for single digit and 5.9 years for multi-digit proximal interphalangeal joint arthroplasty. Comparing single versus multi-digit proximal interphalangeal joint arthroplasty, the reoperation-free survival was 67% and 68% at 5 years and 56% and 67% at 10 years, respectively...
January 1, 2018: Journal of Hand Surgery, European Volume
Farid Najd Mazhar, Davod Jafari, Hamid Taraz, Alireza Mirzaei
This study assessed the outcome of open reduction and internal fixation of proximal interphalangeal joint fracture-dislocations through a shotgun approach, while keeping hemi-hamate arthroplasty as a back-up plan. After using the shotgun approach, fixation was carried out when the anterior fragment was large enough to accept two 1.5 mm screws. Sixty-three fracture-dislocations were treated in 61 patients, of whom 30 underwent internal fixation. Twenty-one of these were assessed in the final study. At a mean follow-up of 29 months, the mean range of joint motion was 80° and 102° for the injured and contralateral hand, respectively...
June 2018: Journal of Hand Surgery, European Volume
Pieter W Jordaan, Duncan McGuire, Michael W Solomons
BACKGROUND: In 2012, our unit published our experience with a pyrocarbon proximal interphalangeal joint (PIPJ) implant. Due to high subsidence rates, a decision was made to change to a cemented surface replacement proximal interphalangeal joint (SR-PIPJ) implant. The purpose of this study was to assess whether the change to a cemented implant would improve the subsidence rates. METHODS: Retrospective review of all patients who had a cemented SR-PIPJ arthroplasty performed from 2011 to 2013 with at least 12 months follow-up...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Scott F M Duncan, Anthony A Smith, Kevin J Renfree, Ross M Dunbar, Marianne V Merritt
BACKGROUND: Most hand surgeons use a dorsal approach for proximal interphalangeal (PIP) joint implant arthroplasty. However, a volar approach offers the advantage of no disturbance to the extensor mechanism, thus allowing early initiation of active range of motion. We examined our results in patients who underwent PIP joint arthroplasty via a volar approach. METHODS: Using a retrospective chart review, we evaluated the outcomes of patients undergoing PIP joint arthroplasty through a volar approach between 2001 and 2005 by 3 fellowship-trained hand surgeons at our institution...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
A Completo, A Nascimento, A F Girão, F Fonseca
BACKGROUND: Pyrocarbon proximal interphalangeal joint arthroplasty provided patients with excellent pain relief and joint motion, however, overall implant complications have been very variable, with some good outcomes at short-medium-term follow-up and some bad outcomes at longer-term follow-up. Implant loosening with migration, dislocation and implant fracture were the main reported clinical complications. The aim of the present work was to test the hypothesis that the magnitude proximal interphalangeal joint cyclic loads in daily hand functions generates stress-strain behaviour which may be associated with a risk of pyrocarbon component loosening in the long-term...
February 2018: Clinical Biomechanics
Jesse F Doty, Jason A Fogleman
Hammer-toe deformities that fail nonoperative treatment can be successfully addressed with proximal interphalangeal joint resection arthroplasty or fusion. The goal of surgery is to eliminate the deformity and rigidly fix the toe in a well-aligned position. Hammer-toe correction procedures can be performed with temporary Kirschner wire (K-wire) fixation for 3 to 6 weeks with high success rates. Pain relief with successful hammer-toe correction approaches 90%; patient satisfaction rates approximate 84%. Although complication rates are rare in most series, there remains a concern regarding exposed temporary K-wire fixation, which has led to the development of multiple permanent internal fixation options...
March 2018: Foot and Ankle Clinics
Russell J Madsen, Lindsay A Stone, Jeremiah B Knapp, Joel S Solomon
BACKGROUND: Traditional approaches to treating painful osteoarthritis of the fingers include arthrodesis and arthroplasty. Although highly effective for pain control, arthrodesis sacrifices joint motion and can be complicated by nonunion, malunion, and infection.Implant arthroplasty preserves motion but is likewise subject to complications-particularly at the level of the proximal interphalangeal joint. In contrast, finger joint denervation is a simple outpatient procedure that maintains joint motion...
January 2018: Annals of Plastic Surgery
Issei Komatsu, Yoshiya Arishima, Hirotomo Shibahashi, Toshihito Yamaguchi, Yoshitaka Minamikawa
BACKGROUND: The Self Locking Finger Joint (SLFJ) implant is a new type of surface replacement implant. The purpose of this study was to evaluate midterm clinical outcomes of the proximal interphalangeal (PIP) arthroplasty with the SLFJ implant. METHODS: We retrospectively studied 26 PIP joint arthroplasties using the SLFJ implant in 17 patients with osteoarthritis or posttraumatic osteoarthritis. Preoperative and postoperative range of motion, grip strength and key pinch, radiographic findings, and complications were evaluated...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
W Kim, B Renaud, P Dumontier, J-L Condamine
The objective of this study was to evaluate the long-term results of proximal interphalangeal (PIP) resurfacing arthroplasty for treating osteoarthritis: the PIP Toccata implant® . This was a retrospective study of 32 out of 33 PIP arthroplasty cases performed with a dorsolateral or a Chamay approach by two surgeons after a minimum follow-up of 24 months. Patients were reviewed using a standardized assessment of pain, function, mobility and radiological changes. The average follow-up was 5.9 years. The mean active range of motion was 67° (15-95)...
December 2017: Hand Surgery and Rehabilitation
Jason J Srnec, Eric R Wagner, Marco Rizzo
Arthritis of the hand can result from inflammatory arthritis, osteoarthritis (OA), or be posttraumatic and can cause pain and debilitation. Arthroplasty serves as 1 surgical option in the surgical management of arthritis and aims to create a pain-free joint with preservation of motion. Although implant arthroplasty of the proximal interphalangeal (PIP), metacarpophalangeal (MCP), and trapeziometacarpal (TMC) joints predictably produce pain relief and high satisfaction, it has historically suffered from high rates of complications...
October 2017: Journal of Hand Surgery
Daniel B Herren
There are increasing numbers of proximal interphalangeal (PIP) arthroplasties performed in Europe. Meanwhile, most surgeons prefer arthroplasty over arthrodesis. Silastic arthroplasties remain the most widely used implants. The main disadvantage of the Silastic implants is the limited stability they provide. Correction of pre-existing deformation is difficult. Soft tissue handling and postoperative scarring have an influence on the results of PIP arthroplasty. Different surgical approaches are possible. The most popular approach in Europe is dorsal...
August 2017: Hand Clinics
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