Cemented Versus Uncemented Surface Replacement Arthroplasty of the Proximal Interphalangeal Joint With a Mean 5-Year Follow-Up

Surface Replacement Arthroplasty of the Proximal Interphalangeal Joint Using a Volar Approach: Case Series

“…We agree with other authors 5,6,19 who have concluded that cemented implants offer the best probability of avoiding subsidence and loosening. Although we have insufficient data to make a definitive conclusion regarding subsidence, our current approach is to broach the canals to accept a sufficiently large component that will provide maximal coverage of the cortical columns of the phalanges.…”

“…The rate of subsidence in cemented joints (4%) was compared to uncemented joints (68%) in a later study, and the authors indicated a strong preference for cement use. 19 Johnstone postulated that an aggressive and early mobilization regimen was important in achieving good ROM and that final outcome might be further improved by enhancing preoperative ROM.…”

Reoperations Following Proximal Interphalangeal Joint Nonconstrained Arthroplasties

“…3,4 Multiple implant designs and surgical approaches in a variety of patient cohorts have been published with variable outcomes. [3][4][5][6][7][8][9][10][11][12][13][14] The most common indications for PIP joint arthroplasty include pain and limited range of motion secondary to primary osteoarthritis and posttraumatic arthritis and in select patients with inflammatory arthritis. The most popular current implant designs are pyrocarbon (Ascension, Inc., Austin, TX) and cobalt chrome with polyethylene (SBI, Mooresville, PA).…”

“…The most popular current implant designs are pyrocarbon (Ascension, Inc., Austin, TX) and cobalt chrome with polyethylene (SBI, Mooresville, PA). [3][4][5][6][7][8][9][11][12][13][14] The most commonly described surgical approaches are dorsal and include the Chamay, 15 the tendon splitting, 12 and the central slip reflecting 1 approaches. Volar and lateral approaches for PIP joint exposure and replacement have also been described.…”

Bone Cement

“…They found that there were significantly more cases with radiographic evidence of loosening in the uncemented group (PϽ.001), leading the author to revert to exclusive use of cemented arthroplasty. 7 There were more cases of joint failure (revision or amputation) in the uncemented group (5 vs 2), but this was not significant (Pϭ.21).…”