Proximal interphalangeal Joint arthroplasty

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Overview of PyroCarbon PIP Clinical Results CLINICAL report Problematic Bone Fixation with PyroCarbon Implants in Proximal Interphalangeal Joint Replacement: Short-Term Results J Hand surg (am.) 2006; 31:643-651 Herren DB, Schindele, S, Goldhahn, J, Simmen BR PYC PIP Purpose The purpose of this study was to review a consecutive series of pyrocarbon PIP joint implants with particular focus on implant anchorage radiologically and the functional status of the replaced joints clinically. Demographics • 17 joints in 14 patients • Average age of patient: 64 years old. Range: 55-81 years old • Indications: o 15 – Degenerative osteoarthritis o 1 – Chondrocalcinosis o 1 – Posttraumatic osteoarthritis “Prosthetic replacement of a destroyed PIP joint may improve function and give good pain relief.” Follow Up • Average follow up of 19 months Results • Range of motion increased from 34° preoperatively to 42° postoperatively • Grip strength improved from 20.3kp to 26kp postoperatively • Significant pain relief for patients, going from 7.6 to 1.3 postoperatively (1-10 scale) • Overall high patient satisfaction CONCLUSION Patients who had stable implants were associated with better results with respect to pain relief and range of motion than devices with migration, although the results were not statistically significant. It seems that the unstable implants, after a phase of migration, settled in a new, more stable position again. This may explain the relatively small effect on clinical results, despite the significant radiological changes. Herren DB, Schindele S, Goldhahn J, Simmen BR. Problematic Bone Fixation with PyroCarbon Implants in Proximal Interphalangeal Joint Replacement: Short-Term Results. J Hand Surg (Br.) 2006; 31: 643-651 10 INTERNAL USE ONLY
Overview of PyroCarbon PIP Clinical Results CASE reportS Intraoperative Fracture of a PyroCarbon PIP Total Joint – A Case Report hand 2007; 2:90-93 Martin Skie, Nicholas Gove, Despina Ciocanel This case report is about a 33 year old man with posttraumatic arthritis of the proximal interphalangeal joint right long finger. The case was treated surgically using the Ascension PyroCarbon PIP total joint. During a proximal interphalangeal joint arthroplasty, the doctors noticed a crack at the neck of the proximal implant. While the articular portion of the implant was easily removed, the removal of the stem required making a 2-3mm burr hole at the proximal end of the stem so that the doctors could use a retractor to push the stem out far enough to retrieve it. Another implant was then inserted without complications. This was the first reported case of a PIP joint implant which was broken during insertion, and the doctors believe the implant fracture occurred because of insufficient volar bone resection at the proximal phalanx. PYC PIP Skie M, Gove N, Ciocanel D. Intraoperative Fracture of a Pyrocarbon PIP Total Joint: A Case Study. Hand 2007; 2:90-93 Creation of Four-Joint-Digit after Second Toe-to-Digit Transplantation: Restoration of Form and Function microsurgery 2008; 28:628-631 Darrell Brooks, MD, Rudolf F. Buntic, MD, Ramon de Jesus, MD The authors describe the non-orthotopic insertion of an Ascension two-piece pyrocarbon proximal interphalangeal joint at the osteosynthesis level of bilateral toe-to-digit transplantations in an attempt to restore both anatomic length and composite fist formation after traumatic multidigit loss. Creation of two four joint fingers by the addition of non-orthotopic joints in toe-todigit reconstructions successfully restored form and function after multidigit loss. Brooks D, Buntic RF, de Jesus, R. Creation of Four-Joint-Digit after Second Toe to Digit Transplantation: Restoration of Form and Function. Microsurgery 2008; 28:628-631 (a) Bilateral second toe-to-digit transplantation restores function after traumatic multi-digit amputation; (b) the discrepancy in toe-to-digit length is highlighted when there are neighboring digits for comparison. (Microsurgery 2008; 28: 629) INTERNAL USE ONLY 11
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Proximal interphalangeal Joint arthroplasty

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