Clinical Conundrum

Jk, Stanley; Ra, Evans

doi:10.1093/rheumatology/31.12.839

Cited by 7 publications

(2 citation statements)

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“…(41) An analysis of radiographs indicated signs of periprosthetic cysts, osteophytes, and loosening of the proximal and distal components of the implant in some patients - short-term complications commonly seen with the silicone prosthesis. (4–12) Range of motion varied greatly, but patient satisfaction was high.…”

Section: Discussionmentioning

confidence: 99%

“…However, this type of implant is not anatomic and implant fracture and dislocation, inflammatory synovitis, joint deformity, heterotopic bone formation, erosive reaction to implant debris, and loss of motion are quite common. (4–12) It has been estimated that silicone-type implant arthroplasty is associated with a 19% complication rate. (4) Advances in small joint arthroplasty demand innovative, anatomic implant designs that are analogous to the advances in hip and knee arthroplasty.…”

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confidence: 99%

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Outcomes of Pyrolytic Carbon Arthroplasty for the Proximal Interphalangeal Joint

Chung

Ram

Shauver

2009

Plastic and Reconstructive Surgery

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Background Arthritis of the PIP joint is a debilitating condition commonly treated with arthroplasty. The pyrolytic carbon (pyrocarbon) implant has been developed for PIP joint arthroplasty in these patients. This prospective outcomes study will evaluate the outcomes and complications of the pyrocarbon implant for the PIP joint. Methods Consecutive candidates for PIP joint arthroplasty with pyrocarbon implant were prospectively evaluated. Functional measurements and the Michigan Hand Outcomes Questionnaire (MHQ) were administered pre-operatively and at 3, 6 and 12 months postoperatively. Pre-operative means and 12-month post-operative means for all functional measures were compared using paired t-tests and nonparametric Wilcoxon signed-rank sum test, and effect size was reported for MHQ. Results Fourteen patients treated with 21 implants enrolled in the study. At the 12-month follow-up period, mean active arc of motion (AAM) was 38°, decreasing slightly from the pre-operative value. Mean grip strength improved from 11.3 kg to 15.1 kg, although the difference was not statistically significant. Mean key pinch values improved significantly from 6.6 kg pre-operatively to 9.2 kg at the 12-month follow-up time (p=0.03). Jebsen-Taylor test scores showed improvement, although not significantly. Changes in all MHQ domains showed high effect size. Complications were minimal. Three patients experienced squeaking of the implant and three patients experienced dislocation of the pyrocarbon joint. Conclusions The pyrocarbon implant for PIP joint arthroplasty shows encouraging results, primarily in patient satisfaction and pain relief, but is associated with complications related to implant dislocations, which required prolonged treatment with external fixators.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%