Der Fingermittelgelenkersatz mit Pyrocarbonprothesen

Abstract

20 patients were treated for posttraumatic or idiopathic arthritis with 24 pyrolytic carbon PIP prostheses, and a follow-up examination was carried out after an average of 15 months (6-30 months). Surgical management was changed from arthroplasty to arthrodesis in three cases. For the remaining prostheses, an average range of motion of 50 degrees was achieved for the proximal interphalangeal joint. On the visual analog scale (VAS; 0: no pain, 10: incapacitating pain), the patients suffered few symptoms (VAS: 0-3). 80% of patients said they were satisfied with the outcome of the operation. In three cases (one infection, two dislocations) the prostheses had to be removed and arthrodesis performed. Migration of the distal components was observed on the radiographs in five cases, and of the proximal components in four cases, although this did not have any effect on the functional parameters. The development of a painless noise ("squeaking") was noticed in nine out of 21 prostheses. However, as with prosthetic migration, this did not cause any functional deficits.

A Modular Surface Gliding Implant (CapFlex-PIP) for Proximal Interphalangeal Joint Osteoarthritis: A Prospective Case Series

“…5 Alternately, several anatomically designed metal, 6,7 pyrocarbon, 8 and ceramic 9 implants are total joint arthroplasties directed at restoring joint function. None of these implants, however, fulfill all the requirements for adequate PIP joint replacement.…”

Proximal interphalangeal (PIP) joint replacements with pyrolytic carbon implants in the hand

“…The overall patient satisfaction and relief from pain have been mostly reported as good. Most authors are continuing to use pyrocarbon implants in such type of surgery, 2,6-8,10,13,14,16,17 while few showed no intention of continuing to use such devices. 7,14,18 …”

“…In fact, the development of a bone apposition process surrounding the bone-pyrocarbon interface, as a symmetrical rim of lucency, may be observed on sequential radiographs up to two years after surgery. 2,6-8,13,17,18 It consists of a high-density bony line surrounding the implant stem and sealing the medullary canal at the level of the tip of the stem. 7,18,19 This process generally intensifies as post-operative mobility is allowed.…”

“…12-19 Post-operative satisfaction and functional ability have been addressed as the clinical parameters associated with variable results, given the generally higher pre-operative patients’ expectations and the actual improvement of range of movement (ROM) after surgery. 6-8,14,17,19,20 From the surgeons’ perspective, the significant percentage of additional procedures or revision surgery (reported as up to 25% and 15%, respectively) represent the concern regarding the use of such implants. 2,6-8,16,17,20 …”

“…6-8,14,17,19,20 From the surgeons’ perspective, the significant percentage of additional procedures or revision surgery (reported as up to 25% and 15%, respectively) represent the concern regarding the use of such implants. 2,6-8,16,17,20 …”