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Development of a surface replacement arthroplasty for proximal interphalangeal joints
R L Linscheid1, P M Murray, M A Vidal
1Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA.
The Journal of Hand Surgery
|March 1, 1997
Summary
Surface replacement proximal interphalangeal prostheses offer good pain relief and motion for arthritic fingers. Dorsal approaches yielded better outcomes than lateral or palmar approaches in this study.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Hand surgery
Background:
- Proximal interphalangeal (PIP) joint arthritis significantly impacts hand function.
- Surface replacement prostheses offer a potential solution for joint reconstruction.
Purpose of the Study:
- To evaluate the long-term outcomes of surface replacement PIP joint prostheses.
- To assess the influence of surgical approach on functional results.
Main Methods:
- A retrospective study of 66 surface replacement PIP joint prostheses (CrCo proximal, UHMWPE distal) in 47 patients over 14 years.
- Analysis of outcomes based on pain relief, motion, and deformity.
- Comparison of results across different etiologies (degenerative, traumatic, rheumatoid arthritis) and surgical approaches (dorsal, lateral, palmar).
Main Results:
- Overall good results were achieved in 32 fingers, fair in 19, and poor in 15.
- Poor outcomes were associated with prior extensive injury or static deformity.
- Dorsal surgical approach demonstrated superior results compared to lateral or palmar approaches.
- Minimal component loosening was observed in one case.
Conclusions:
- Surface replacement PIP joint arthroplasty can provide satisfactory functional restoration for various types of arthritis.
- Surgical technique, particularly the dorsal approach, is crucial for optimal outcomes.
- Long-term results are generally stable after the first year, with overall improvements noted over time, likely due to enhanced surgical experience.