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Proximal interphalangeal joint surface replacement effectively corrects severe preoperative axis deviations, yielding similar patient outcomes compared to non-deviated joints. However, the risk of revision surgery is higher in deviated joints.

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Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Biomedical engineering

Background:

  • Proximal interphalangeal (PIP) joint deformities can significantly impact hand function.
  • Surgical correction of severe preoperative longitudinal axis deviation in PIP joints is a clinical challenge.
  • Surface replacement arthroplasty is a potential treatment option for PIP joint reconstruction.

Purpose of the Study:

  • To compare 2-year outcomes of proximal interphalangeal joint surface replacement in patients with and without severe preoperative longitudinal axis deviation.
  • To evaluate the efficacy of PIP joint surface replacement in correcting preoperative axis deviations.
  • To assess functional outcomes, pain, and complication rates following PIP joint surface replacement.

Main Methods:

  • A comparative study involving 68 joints with severe (>15°) preoperative deviation and 50 joints with minimal (<5°) deviation.
  • Patients underwent proximal interphalangeal joint surface replacement.
  • Outcomes including the Michigan Hand Outcomes Questionnaire (mHOQ), pain, range of motion, grip strength, and complications were assessed at 2-year follow-up.

Main Results:

  • Both groups showed similar mean 2-year mHOQ scores (72 for severe deviation vs. 70 for no deviation).
  • No significant differences were observed in pain, range of motion, grip strength, or complications between the groups at 2 years.
  • Ninety percent of severely deviated joints achieved <15° deviation postoperatively, with revision rates of 5.9% for deviated and 1.8% for non-deviated joints.

Conclusions:

  • Proximal interphalangeal joint surface replacement is effective in correcting severe preoperative axis deviations, with comparable functional outcomes to non-deviated joints.
  • While the implant corrects deformity, the increased risk of revision surgery in deviated joints warrants consideration.
  • Surface replacement arthroplasty is a viable option for PIP joint reconstruction in the presence of significant preoperative axis deviation.