Surgical approaches for proximal interphalangeal joint arthroplasty

Renfree, Kevin J.

doi:10.1302/0301-620x.104b12.bjj-2022-0946

Cited by 3 publications

(1 citation statement)

References 19 publications

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“…Для эндопротезирования проксимального межфалангового сустава кисти используют различные хирургические доступы в зависимости от потребностей и опыта хирурга [25,26]. В нашей практике мы используем исключительно тыльный доступ.…”

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The long-term results of proximal interphalangeal joint arthroplasty of the hand

Fedotov,

Kovalev,

Rybakov

2024

jour

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Introduction Small joints replacement is a valid treatment for deforming osteoarthritis and traumatic injuries to the phalangeal joints of the hand to restore motor hand functions. Various types of implants differing in shape, biomechanics and material composition have been developed.The purpose of the study was to evaluate long-term results of the proximal interphalangeal joint arthroplasty of the hand using various implants and identify their advantages.Material and methods We retrospectively reviewed 78 cases of proximal interphalangeal joint replacement in 64 patients. Outcomes were assessed at 6 months and at follow-up stages with preoperative and postoperative measurements of the range of motion in the joint evaluating pain, radiographs and outcomes measures using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.Results The range of motion in the prosthetic joint increased significantly at different follow-up periods with all types of implants. The pain syndrome decreased. Radiographs revealed 10 cases of aseptic instability in the group of constrained prostheses. The DASH assessment showed high subjective satisfaction with the treatment.Discussion We could not find papers reporting PIP joint arthroplasty using SBI D.G.T. implant system. A retrospective study of RM Finger arthroplasty of the PIP joint indicated restored joint stability with AROM improvement and with low pain, although it had a high rate of complications. We recorded no complications with this implant model. Some authors would not recommend the RM Finger implant (Mathys) for PIP joint replacement. Arthroplasty of small joints of the hand with MOJE kermik-implantate showed satisfactory outcomes for 82 % of patients at a long term.Conclusion Arthroplasty of the PIP joint of the hand using various implant designs resulted in greater mobility of the upper limbs, a lower pain due to subjective improvement in the functionality at a long term. Although the procedures were effective with all implant designs the reliability of changes in the parameters was more evident with nonconstrained implants.

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Section: Discussionunclassified

The long-term results of proximal interphalangeal joint arthroplasty of the hand

Fedotov,

Kovalev,

Rybakov

2024

jour

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Dorsal and Volar Approaches for Proximal Interphalangeal Joint Replacement: Comparing Outcomes Through Systematic Review and Meta-Analysis

Mahi,

Ansong,

Gan

et al. 2024

Hand (New York, N,Y.)

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Background: The 2 primary surgical approaches for proximal interphalangeal joint (PIPJ) arthroplasty, dorsal or volar, have been extensively described in the literature. However, the ongoing debate regarding which approach offers superior results or is associated with fewer complications persists. This systematic review aims to compare the outcomes of PIPJ arthroplasty between the dorsal and volar approaches. Methods: A comprehensive search of multiple databases was conducted, and studies meeting predetermined criteria were included. Data extraction, assessment of bias risk, and statistical analysis were performed to compare treatment modalities. Outcome measures included range of motion (ROM), patient-reported outcome measures (PROMs), revisions, and reported complications. Results: Among 368 screened articles, 5 studies involving 302 patients (310 implants) were eligible for final review. No significant differences were observed between the 2 approaches regarding postoperative ROM (mean difference [MD] 2.24; 95% confidence interval [CI] −3.83, 8.32; P = .47) and PROMs (standardized mean difference [SMD] 0.18; 95% CI −0.12, 0.48; P = .25). Complication rates, including revision/fusion, persistent pain, stiffness, infection, and dislocation, did not significantly differ between the approaches. Notably, dorsal approach was associated with higher risk of swan-neck deformity (9 out of 82 implants), while no such cases were reported in the volar approach (0 out of 101 implants). Conclusion: Despite limitations and heterogeneity in the literature, both dorsal and volar approaches for PIPJ arthroplasty appear to yield equivalent outcomes for patients. Level of Evidence: II, therapeutic.

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Arthroplasty of the proximal interphalangeal joint of the hand: the current state of the problem

Fedotov,

Kovalev,

Mikhailov

2024

jour

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Introduction The proximal interphalangeal joint (PIP joint) plays an important role in ensuring optimal finger dexterity, grip strength and overall hand functionality. Arthroplasty is a promising direction in the surgical treatment of arthritis of the PIP joint of the hand, however, the inconsistency of the results encourages the world scientific community to be restrained and further investigate the problems associated with PIP joint arthroplasty.The purpose of the work was to identify the main problems of PIP joint arthroplasty based on the analysis of foreign and domestic medical literature.Materials and methods In this literature review, an analysis of foreign and domestic scientific publications devoted to the treatment of diseases and injuries of PIP joint was carried out. The purpose of the study was to provide a brief historical background and identify the main problems of PIP joint arthroplasty based on the analysis of foreign and domestic medical literature.Results and discussion The choice of the implant and the surgical aproach used are the two most frequently discussed issues in PIP joint arthroplasty; dorsal, palmar and lateral surgical approaches are described, each with its own advantages and disadvantages. Dorsal approaches are used most often because they are easier to perform; however, the fragile extensor apparatus is damaged with the subsequent development of extensor lag. A number of authors concluded that stiffness and extensor lag were the most common postoperative complications. Several combinations of materials are available: from classic chrome-cobalt/polyethylene to ceramic/ceramic and pyrocarbon/pyrocarbon. Most of them have not stood the test of time yet, and for most implants there is still a lack of real long-term monitoring series for survival of the design.Conclusion The morphology of joints, small bone sizes, complex biomechanics and the load on the hand are a special problem in PIP joint arthroplasty. It is still not possible to restore the full range of motion in this joint, despite the success of colleagues in arthroplasty of large joints.

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Surgical approaches for proximal interphalangeal joint arthroplasty

Cited by 3 publications

References 19 publications

The long-term results of proximal interphalangeal joint arthroplasty of the hand

The long-term results of proximal interphalangeal joint arthroplasty of the hand

Dorsal and Volar Approaches for Proximal Interphalangeal Joint Replacement: Comparing Outcomes Through Systematic Review and Meta-Analysis

Arthroplasty of the proximal interphalangeal joint of the hand: the current state of the problem

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