Early results with osseointegrated proximal interphalangeal joint prostheses

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Rheumatology

Background:

• Degenerative joint diseases like rheumatoid arthritis and osteoarthritis commonly affect the proximal interphalangeal (PIP) joints.
• Traditional treatments may not fully restore function or alleviate pain, necessitating innovative prosthetic solutions.

Purpose of the Study:

• To evaluate the early clinical outcomes of osseointegrated endoprostheses for PIP joint replacement.
• To assess the efficacy, safety, and patient satisfaction associated with this novel surgical approach.

Main Methods:

• A cohort of 12 patients underwent 22 PIP joint replacements using screw-shaped titanium fixtures and a silicone spacer.
• The procedure involved joint resection, cancellous bone grafting, and implant insertion in a single stage.
• Follow-up included clinical assessment of range of motion, extension lag, and radiographic evaluation of osseointegration.

Main Results:

• High osseointegration rates (41 of 44 fixtures) were observed at an average follow-up of 27 months.
• Significant improvements in active range of motion (average 56 degrees) and hand function were noted.
• High patient satisfaction (20 of 22 joints) was reported, with pain relief and improved grip strength. However, 4 spacers fractured and 27% showed deformation.

Conclusions:

• Osseointegrated implants offer favorable early clinical results for PIP joint arthroplasty, enhancing patient function and satisfaction.
• The study highlights the need for improved material durability, particularly for the silicone joint spacer, to ensure long-term implant success.