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Proximal interphalangeal joint silicone arthroplasty for posttraumatic arthritis
J J Hage1, E P Yoe, J P Zevering
1Department of Plastic and Reconstructive Surgery, Academisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands.
The Journal of Hand Surgery
|February 27, 1999
Summary
Silicone implant arthroplasty offers good subjective function and pain relief for proximal interphalangeal joint destruction. However, objective measures like range of motion and strength often show limitations, with poor correlation to patient satisfaction.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Reconstructive Surgery
Background:
- Severe proximal interphalangeal (PIP) joint destruction often necessitates reconstructive procedures.
- Silicone implant arthroplasty is a treatment option for post-traumatic arthrosis of the PIP joint.
Purpose of the Study:
- To evaluate the long-term outcomes of silicone implant arthroplasty for severe PIP joint destruction.
- To assess the correlation between subjective patient satisfaction and objective functional results.
Main Methods:
- Retrospective evaluation of 16 silicone implant arthroplasties in 14 patients with severe PIP joint destruction.
- Assessment of subjective outcomes using a visual analog scale for function and daily living activities.
- Objective evaluation included range of motion, lateral deviation, rotational deformity, and pinch strength compared to the contralateral hand.
Main Results:
- Subjective evaluations averaged 73/100 for function and daily living, with most patients reporting pain relief.
- Objective measures showed an average active motion of 47% of the contralateral side, average lateral deviation of 4 degrees, average rotational deformity of 8 degrees, and average pinch strength of 75% of the contralateral side.
- A poor correlation was observed between subjective patient satisfaction and objective functional outcomes.
Conclusions:
- Silicone implant arthroplasty can provide satisfactory subjective results, particularly pain relief, in patients with post-traumatic PIP joint arthrosis.
- Objective outcomes, including range of motion and strength, may be suboptimal and do not consistently correlate with patient-reported satisfaction.
- This procedure may be best indicated for cases where adhesions can be addressed with tenolysis, enabling early active motion, though objective results may still lag behind subjective improvements.