Pyrocarbon Proximal Interphalangeal Joint Arthroplasty: Minimum Five-Year Follow-Up

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Hand surgery

Background:

• Proximal interphalangeal (PIP) joint arthroplasty is a treatment for arthritis.
• Pyrocarbon implants are used for PIP joint replacement.
• Long-term outcomes of pyrocarbon PIP joint arthroplasty require further investigation.

Purpose of the Study:

• To evaluate the long-term outcomes, complications, and survivorship of pyrocarbon PIP joint arthroplasty.
• To assess functional and radiological results at a minimum of 5-year follow-up.

Main Methods:

• Retrospective review of 97 pyrocarbon PIP joint implants in 72 patients.
• Data collected included demographics, complications, and revision surgeries.
• Outcomes assessed via grip strength, range of motion, radiological evaluation, and patient-reported scores (PEM, QuickDASH, VAS).

Main Results:

• Average follow-up was 118 months.
• Mean arc of motion was 35°, with no significant difference in grip strength compared to the contralateral side.
• 36% of implants required further surgery (14 revisions, 22 reconstructions); 85% implant survival at 5 and 10 years.
• Radiologically, 48% showed progressive loosening, though this did not always necessitate revision.

Conclusions:

• Pyrocarbon PIP joint arthroplasty provides good pain relief and maintains range of motion.
• Implant revision rates were higher than with alternative prostheses.
• Most revisions occurred within 24 months of the initial surgery.