Prediction of adverse events in proximal interphalangeal joint surface-replacement implants

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Hand surgery

Background:

• Proximal interphalangeal joint (PIPJ) surface replacement aims to restore function and reduce pain.
• Adverse events and implant revision are significant concerns following PIPJ arthroplasty.
• Predictors of long-term outcomes after PIPJ surface replacement require further investigation.

Purpose of the Study:

• To identify predictors of adverse events and implant revision risk up to 10 years after PIPJ surface replacement.
• To analyze the impact of patient, surgical, and implant factors on PIPJ arthroplasty outcomes.

Main Methods:

• Registry-based analysis of 476 CapFlex-PIP prostheses implanted between 2010 and 2024.
• Logistic regression models used to assess predictors of limited range of motion, implant problems, and revision surgery.
• Covariates included sociodemographic data, clinical measures, patient-reported outcomes, and surgical details.

Main Results:

• Younger age and prior hand surgeries correlated with reduced range of motion.
• The little finger showed a higher risk of implant-related problems.
• Increased surgical experience significantly reduced implant-related problems (83%) and revision surgery (76%).

Conclusions:

• Greater surgical experience is a key factor in minimizing adverse events and revision needs after PIPJ surface replacement.
• While surgical experience is important, it explains only a small portion of adverse event variance, indicating other contributing factors.
• Further research is needed to elucidate the multifactorial nature of adverse events in PIPJ arthroplasty.