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Proximal interphalangeal joint arthroplasty.

R F Dryer, W F Blair, D G Shurr

    Clinical Orthopaedics and Related Research
    |May 1, 1984
    PubMed
    Summary
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    Proximal interphalangeal (PIP) joint arthroplasty using Flatt, Swanson, or Niebauer implants showed limited long-term benefits for rheumatoid hand reconstruction. While patient satisfaction remained high, functional outcomes and range of motion declined over time.

    Area of Science:

    • Orthopedic surgery
    • Rheumatology
    • Biomedical engineering

    Background:

    • Prosthetic implant arthroplasty of the proximal interphalangeal (PIP) joint is utilized in rheumatoid hand reconstruction.
    • The efficacy and long-term outcomes of different PIP joint prostheses require thorough evaluation.

    Purpose of the Study:

    • To review the clinical results of Flatt, Swanson, and Niebauer PIP joint arthroplasties in rheumatoid hand patients.
    • To assess the functional outcomes, range of motion, and radiographic findings associated with these implants over time.

    Main Methods:

    • Retrospective review of 93 PIP joint arthroplasties (56 Flatt, 30 Swanson, 7 Niebauer).
    • Postoperative follow-up averaged 6.2 years.
    • Evaluation of maximum extension/flexion, active range of motion, and radiographic complications.

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    Main Results:

    • Average active motion: Flatt (15°), Swanson (37°), Niebauer (19.5°).
    • Active motion decreased over ten years for all implant types.
    • Radiographic issues included cortical perforation (Flatt, 80%) and swan-neck deformity (Swanson, 27%).

    Conclusions:

    • PIP joint arthroplasty in rheumatoid hands yields suboptimal clinical results with declining function.
    • Despite functional limitations, patient satisfaction and activities of daily living were generally acceptable.
    • Long-term effectiveness of these specific PIP joint prostheses is questionable.