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Lateral stability of proximal interphalangeal joint replacement
Y Minamikawa1, T Imaeda, P C Amadio
1Division of Hand Surgery, Mayo Clinic, Rochester, MN 55905.
The Journal of Hand Surgery
|November 1, 1994
Summary
This study compared silicone implants versus surface replacement prostheses for proximal interphalangeal joint stability. Silicone implants showed significantly increased lateral instability in finger joints after replacement.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Hand Surgery
Background:
- Proximal interphalangeal (PIP) joint injuries can impair hand function.
- Implant arthroplasty is a treatment option for PIP joint reconstruction.
- Understanding joint stability after implantation is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the lateral stability of the cadaver proximal interphalangeal joint.
- To compare the stability after replacement with a silicone rubber flexible implant versus a custom surface replacement prosthesis.
Main Methods:
- Ten cadaver middle fingers were used.
- Joints were randomly assigned for replacement with either silicone or surface replacement implants.
- An electromagnetic tracking system measured lateral angulation under tendon loading before and after implantation.
Main Results:
- Intact PIP joints showed minimal lateral angulation (4° in extension, 8° in 60° flexion).
- Surface replacement prostheses increased lateral angulation in flexion (>20°), but not significantly compared to intact joints.
- Silicone implants resulted in more pronounced lateral angulation, even in extension, and significantly more in flexion (>20°).
Conclusions:
- Silicone rubber flexible finger joint implants significantly compromise lateral stability of the proximal interphalangeal joint.
- Surface replacement prostheses offer comparable lateral stability to intact joints in most flexion angles.
- Further research into implant design is needed to improve stability in PIP joint reconstructions.