Hypothesis: Arthroplasty remains an established motion preserving treatment for proximal interphalangeal (PIP) joint arthritis. The aim of this report is to review clinical, subjective and radiographic results of pyrocarbon hemi-arthroplasty in the treatment of PIP arthritis.
Methods: 45 fingers in 40 patients underwent hemiarthroplasty between 2005 and 2011. Preoperative diagnoses included 30 with osteo or post-traumatic arthritis and 10 with inflammatory arthritis. The female to male ratio was 33:7. The average age at time of surgery was 56 years. The average follow-up period was 4.62 years. A student’s t-test was used to assess statistical significance.
Results: To date there has been significant improvement in patient satisfaction measures including COPM (performance and satisfaction) scores and DASH as well as VAS pain scores. There was no significant change in ROM, grip and pinch strength following surgery. Four joints were revised for failure: 3 underwent salvage to succesful arthrodesis and another was converted to a silicone hinged PIP arthroplasty. Radiographic positions of the implant demonstrate a Sweets and Stern grade 0 in 44 implants to date and grade 3 in one.
Summary Points: PIP pyrocarbon hemiarthroplasty appears to be a viable alter-native to PIP arthroplasty in the treatment of PIP joint arthritis. Clinical and patient satisfaction outcomes compare favorably with published outcomes of arthroplasty. Radiographic outcomes are encouraging with respect to implant positioning and loosening. Hemiarthroplasty affords a simpler procedure that preserves more bone stock which hopefully allows for better success of salvage options such as fusion and revision arthroplasty. Indications are still being refined and longer term outcomes will better validate its use.