Proximal interphalangeal Joint arthroplasty

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Overview of PyroCarbon PIP Clinical Results competitive studies Cemented Versus Uncemented Surface Replacement Arthroplasty of the Proximal Interphalangeal Joint With a Mean 5-Year Follow-Up j hand surg 2008; 33a:726-732 Johnstone BR, Fitzgerald M, Smith KR, Currie LJ PYC PIP Purpose To retrospectively compare the long-term results of SBi cemented and uncemented surface replacement arthroplasties of the proximal interphalangeal (PIP) joint in a single surgeon’s experience. Demographics • 48 Avanta SR PIP joints in 32 patients o 27 cemented joints in 18 patients o 18 uncemented joints in 18 patients • Average age of patient o Cemented group: 53 years old o Uncemented group: 56 years old • Indications: o 22 – Osteoarthritis o 6 – Seronegative arthritis o 4 – Rheumatoid arthritis o 11 – Posttraumatic problems “Our study has shown significant problems with loosening uncemented implants (p
Overview of PyroCarbon PIP Clinical Results competitive studies Surface Replacement Arthroplasty of the Proximal Interphalangeal Joint Using the PIP-SRA Implant: Results, Complications, and Revisions j hand surg 2008; 33a:1565-1572 Charles D. Jennings, MD, Douglas P. Livingstone, BS Purpose To evaluate the subjective and objective results of surface replacement arthroplasty (SRA) for arthritis of the proximal interphalangeal (PIP) joint using the PIP-SRA implant. Emphasis is placed on causes of complications, failures, and techniques used for revision. Demographics • 43 arthroplasties in 25 patients • Average age of patient: 62 years old. Range: 20-80 years old • Indications: o 39 – Osteoarthritis o 2 – Posttraumatic arthritis o 2 – Rheumatoid arthritis PYC PIP Follow Up • Average follow-up time: 37 months Results • Arc of motion o PIP motion increased 1° postoperatively (from 57° to 58°) o DIP motion decreased 12° postoperatively (from 36° to 24°) • Patient satisfaction rating o 60% Very satisfied o 28% Fairly satisfied o 12% Not satisfied • Complications: o Stress shielding in 15 components o Peri prosthetic radiolucency in 9 components o Loosening in 16 components o 26% revision rate (11 out of 43) o 4% of cemented prosthesis loosened (2 out of 45) o 39% of uncemented prosthesis loosened (16 out of 41) B) Patient 15, right index finger, showing loosening, with migration of proximal component. (C) Patient 9, right long finger, showing stress shielding (most extreme case). J Hand Surg 2008; 33A: 1565 CONCLUSION Surface replacement arthroplasty of the PIP joint holds promise for the future. It offers motion and stability for the index finger unattainable with silicone arthroplasty. These results do not differ notable from those of other series using this implant, except that failures due to loosening in this study were almost exclusively associated with the lack of cement. Therefore, the authors recommend using cement with the PIP-SRA implant in every case until superior long-term results can be demonstrated using uncemented components. Proximal Interphalangeal joint arthroplasty is an exacting procedure no matter what technique or implant is used, and no on technique has yet been proven superior to all others. Jennings CD, Livingston DP. Surface Replacement Arthroplasty of the Proximal Interphalangeal Joint Using the PIP-SRA Implant: Results, Complications, and Revisions. J Hand Surg 2008; 33A: 1565-1572 INTERNAL USE ONLY 15
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Proximal interphalangeal Joint arthroplasty

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