Proximal interphalangeal Joint arthroplasty

Overview of PyroCarbon PIP Clinical Results
CLINICAL report
Resurfacing Arthroplasty versus Silicone Arthroplasty
for Proximal Interphalangeal Joint Osteoarthritis
journal of hand surgery (Am.) 2007; 33:775-788
Branam BR, Tuttle HG, Ster PG, Levin L
PYC PIP
Purpose
The purpose of this study is to compare the outcomes of silicone proximal interphalangeal joint (PIPJ) arthroplasties to pyrolytic
carbon implants in patients with osteoarthritis.
Demographics
• 41 arthroplasties in 22 patients
o Silicone: 13 patients and 33 joints.
o PyroCarbon: 9 patients and 19 joints.
• Average age 62 years old
• Indications: All patients had severe osteoarthritis and
had failed nonoperative treatment
Follow Up
• Silicone group: average follow up of 45 months
• PyroCarbon group: average follow up of 19 months
“Major problem with silicone,
their inability to correct or resist
progressive joint deformity.
Implant fracture or failure occurred
moderately frequently in
the silicone group.”
Results
• ROM
o Silicone group exhibited a 4° decrease in ROM
o PyroCarbon group exhibited a 1° increase in ROM
• Grip Strength
o Silicone pre-op 18Kg post op 19Kg (1Kg increase)
o PyroCarbon pre-op 9Kg post op 14Kg (5Kg increase)
• Average satisfaction score (out of 10)
o Silicone 6.2
o PyroCarbon 8.1
• Complications
o Silicone had 3 major complications
o No major complications in the pyrolytic carbon group
• Appearance
o 8 silicone patients believe appearance of their joint
was worse postoperatively
o 16 PyroCarbon patients noted improved appearance
of their joint postoperatively
Radiograph of the patient who had pipj pyrolytic carbon
arthroplasty of the index finger and silicone arthroplasties
of the middle and small fingers. Anterposterior radiograph
at 4.5 months postoperatively showing marked radial
deviation of the middle finger pipj.
J Hand Surg 2007; 32A:781
CONCLUSION
Both implants provide excellent pain relief and comparable postoperative range of motion. Complications were
implant specific. The results of this series show promise for the pyrolytic carbon PIPJ resurfacing arthroplasty but
did not clearly demonstrate superiority compared with the silicone implant.
Branam BR, Tuttle HG, Ster PG, Levin L. Resurfacing Arthroplasty versus Silicone Arthroplasty for Proximal Interphalangeal Joint Osteoarthritis. J Hand Surg 2007; 32A: 775-788
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INTERNAL USE ONLY