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[DIGITOS-prosthesis for the proximal interphalangeal joint--long-term results]
1Abteilung für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Steinhövelstrasse 9, 89075 Ulm. joachim.guelke@uniklinik-ulm.de
Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|August 29, 2007
Summary
The DIGITOS-prosthesis for proximal interphalangeal joint arthritis offers pain relief and patient satisfaction. However, range of motion significantly decreases over seven years post-surgery.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Biomaterials Science
Background:
- Proximal interphalangeal (PIP) joint arthritis significantly impacts hand function and quality of life.
- Surgical options for painful PIP joint arthritis include arthrodesis (joint fusion) and arthroplasty (joint replacement).
- Various prosthetic designs exist for PIP joint replacement, necessitating evaluation of their long-term efficacy.
Purpose of the Study:
- To prospectively evaluate the 7-year outcomes of the DIGITOS-prosthesis for middle joint replacement in patients with proximal interphalangeal joint arthritis.
- To assess functional recovery, pain levels, and patient satisfaction following DIGITOS-prosthesis implantation.
Main Methods:
- A prospective study involving 14 patients who received 17 DIGITOS-prostheses for PIP joint replacement between 1996 and 1999.
- Follow-up evaluation extended to seven years, assessing range of motion, radiographic findings, pain, and patient satisfaction.
- Radiographic assessment focused on radiolucency, osteophytes, cortical penetration, luxation, and implant fractures.
Main Results:
- All 17 prostheses showed minimal radiolucent lines at the bone-cement junction and significant periarticular osteophytes at 7-year follow-up.
- No cases of cortical penetration, luxation, or implant fractures were observed.
- Preoperative median range of motion was 50 degrees, improving to 60 degrees postoperatively, but declining to 30 degrees by 7 years.
- Preoperative pain (11 with activity, 3 without) significantly reduced, with only 2 patients experiencing pain at work during the follow-up period.
- All patients reported satisfaction with the surgical outcome and would opt for the same treatment again.
Conclusions:
- The DIGITOS-prosthesis provides significant pain relief and high patient satisfaction for proximal interphalangeal joint arthritis over a 7-year period.
- While the prosthesis demonstrates good implant survival without major complications like fracture or dislocation, a notable decline in range of motion occurs over time.
- Further research into long-term functional preservation and alternative surgical strategies for PIP joint arthritis may be warranted.