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. 2022 Mar;17(2):266-270.
doi: 10.1177/1558944720921468. Epub 2020 May 26.

The Long-term Results of Proximal Interphalangeal Joint Arthroplasty of the Osteoarthritic Index Finger

Tomos Richards  1 , Laura Ingham  1 , Ian Russell  1 , David Newington  1
Affiliations

The Long-term Results of Proximal Interphalangeal Joint Arthroplasty of the Osteoarthritic Index Finger

Tomos Richards et al. Hand (N Y). 2022 Mar.

Abstract

Background: Arthroplasty of the proximal interphalangeal (PIP) joint is a widely performed procedure for patients with osteoarthritis. Its use in the index finger is often discouraged due to concerns over implant longevity and stability secondary to coronal forces this digit is exposed to during pinch. Methods: We analyzed 47 consecutive index finger silastic interposition arthroplasties, performed through a dorsal approach, at a mean follow-up of 5.15 years. Results: Only 2 patients had ulnar deviation greater than 15°. The reoperation rate was 12.8%, with only 1 finger requiring arthrodesis. The mean Visual Analog Scale score was 1.1; and of the whole series, only 1 patient would retrospectively have preferred a fusion. Conclusions: Our series shows that excellent functional results and patient satisfaction can be gained using silastic PIP joint arthroplasty in the index finger. We would advocate offering this procedure, especially in lower demand patients as an alternative to arthrodesis, with the benefit of providing good pain relief while preserving movement.

Keywords: anatomy; arthritis; arthroplasty; diagnosis; digits; pain management; research and health outcomes; specialty; treatment.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Dorsal extensor tendon split and elevation, bony resection, coronal plane balance, and trial and definitive prosthesis with active flexion.
Figure 2.
Figure 2.
Good postoperative improvement in functional movement at the index proximal interphalangeal joint.
Figure 3.
Figure 3.
Preserved key pinch and flexion despite significant ulnar drift.
See this image and copyright information in PMC

References

    1. Dickson DR, Nuttall D, Watts AC, et al.. Pyrocarbon proximal interphalangeal joint arthroplasty: minimum five-year follow-up. J Hand Surg Am. 2015;40(11):2142-2148. - PubMed
    1. Vitale MA, Fruth KM, Rizzo M, et al.. Prosthetic arthroplasty versus arthrodesis for osteoarthritis and posttraumatic arthritis of the index finger proximal interphalangeal joint. J Hand Surg Am. 2015;40(10):1937-1948. - PubMed
    1. Pellegrini VD, Burton RI. Osteoarthritis of the proximal interphalangeal joint of the hand: arthroplasty or fusion? J Hand Surg Am. 1990;15:194-209. - PubMed
    1. Uchiyama S, Cooney WP, 3rd, Linscheid RL, et al.. Kinematics of the proximal interphalangeal joint of the finger after surface replacement. J Hand Surg Am. 2000;25(2):305-312. - PubMed
    1. Milone MT, Klifto CS, Hacquebord JH. Prosthetic arthroplasty of proximal interphalangeal joints for treatment of osteoarthritis and posttraumatic arthritis: systematic review and meta-analysis comparing the three ulnar digits with the index finger. Hand. 2018;14:658-663. - PMC - PubMed

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