Problematic bone fixation with pyrocarbon implants in proximal interphalangeal joint replacement: short-term results.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Device Technology

Background:

• Proximal interphalangeal (PIP) joint arthritis significantly impacts hand function and quality of life.
• Pyrocarbon prostheses offer a potential solution for PIP joint arthroplasty, aiming to restore motion and reduce pain.

Purpose of the Study:

• To prospectively evaluate the clinical and radiographic outcomes of pyrocarbon PIP joint prostheses.
• To assess the long-term durability and potential complications associated with uncemented press-fit pyrocarbon implants.

Main Methods:

• Seventeen pyrocarbon PIP prostheses were implanted in 14 patients.
• Patients underwent prospective follow-up for a mean of 20.5 months.
• Clinical assessment included VAS pain scale, range of motion, and grip strength; radiographic assessment evaluated component migration and radiolucent lines.

Main Results:

• Significant pain reduction was observed, with VAS pain scores decreasing from 7.6 pre-operatively to 1.3 at final follow-up.
• Radiographic evaluation revealed component migration in eight joints and radiolucent lines in three joints.
• While migrated implants showed less favorable range of motion and grip strength, the difference was not statistically significant.

Conclusions:

• Pyrocarbon PIP prostheses can achieve significant pain relief.
• The observed rates of component migration and radiolucent lines question the suitability of pyrocarbon for uncemented press-fit fixation in PIP joints with early functional rehabilitation.
• Further investigation is warranted to optimize fixation methods and material choices for pyrocarbon PIP joint arthroplasty.