Managing Difficult Problems in Small Joint Arthroplasty: Challenges, Complications, and Revisions.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Small joint arthroplasty has been used for hand joint preservation and pain relief for over 50 years.
• Metacarpophalangeal (MCP), proximal interphalangeal (PIP), and carpometacarpal (CMC) joint arthroplasty have not consistently achieved the long-term success of hip and knee replacements.
• Complications can significantly impact patient outcomes following these procedures.

Purpose of the Study:

• To outline the common complications associated with MCP, PIP, and CMC joint arthroplasty.
• To provide guidance on the management strategies for these complications.
• To prepare hand surgeons for potential issues arising from hand joint replacement surgery.

Main Methods:

• Review of common complications following MCP, PIP, and CMC joint arthroplasty.
• Discussion of management techniques for identified complications.
• Emphasis on surgeon preparedness for adverse events.

Main Results:

• Common complications include intraoperative fracture, postoperative dislocation, persistent pain, restricted motion, and joint instability.
• Effective management strategies are crucial for successful patient recovery.
• Surgeons must be equipped to handle a range of potential post-arthroplasty issues.

Conclusions:

• MCP, PIP, and CMC joint arthroplasty, while beneficial, are prone to specific complications.
• Proactive understanding and management of these complications are essential for optimal surgical outcomes.
• This article serves as a resource for hand surgeons managing post-arthroplasty complications.