PDF herunterladen
J Hand Microsurg 2021; 13(03): 132-137
DOI: 10.1055/s-0040-1709088
Original Article

Factors Associated with Reoperation after Pyrocarbon Proximal Interphalangeal Joint Arthroplasty for the Arthritic Joint: A Retrospective Cohort Study

Bo J. W. Notermans
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Jonathan Lans 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Ryan P. Ponton
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Jesse B. Jupiter 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Neal C. Chen 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
› Institutsangaben
Funding None.
› Weitere Informationen
  Lizenzen und Reprints

Abstract

Introduction The rate of reoperation after pyrocarbon proximal interphalangeal (PIP) joint arthroplasty ranges from 5.9 to 37% and complications such as radiographic loosening, deformity, dislocation, and stiffness are common. Because of the limited amount of knowledge around these problems, we evaluated factors associated with reoperation after pyrocarbon PIP arthroplasty.

Materials and Methods We retrospectively included all adult patients that underwent primary PIP pyrocarbon implant arthroplasty between 2002 and 2016 at one institutional system. A total of 45 patients, with a mean age of 55 (standard deviation: 14), underwent 66 PIP arthroplasties. To address for within individual correlations, we only included fingers treated at patients’ initial surgery (n = 54) in our statistical analysis. These patients were predominantly diagnosed with noninflammatory arthritis 73% (n = 33). Arthroplasty was performed upon 10 index, 22 middle, 20 ring, and 2 small fingers.

Results The reoperation rate after pyrocarbon PIP arthroplasty was 30% over a median follow-up of 25 months (interquartile range: 8.7–54). Indications for reoperation consisted of subluxation (n = 6), stiffness (n = 5), swan-neck deformity (n = 3), and soft tissue complications (n = 2). Younger age (p = 0.025), male sex (p = 0.017), and noninflammatory arthritis (p = 0.038) were associated with a higher reoperation rate.

Conclusion In this study, our reoperation rate after pyrocarbon PIP arthroplasty was 30%. This study suggested that younger patients, males, and patients with noninflammatory arthritis are at higher risk of reoperation. We recommend considering these factors when selecting candidates for pyrocarbon arthroplasty. Future studies should focus on prospectively researching these factors in comparison with other implants.

Keywords

proximal interphalangeal arthroplasty - pyrocarbon arthroplasty - finger arthroplasty


Publikationsverlauf

Artikel online veröffentlicht:
09. April 2020

© 2021. Society of Indian Hand & Microsurgeons. All rights reserved. Thieme Medical and Scientific

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Zhang Y, Niu J, Kelly-Hayes M, Chaisson CE, Aliabadi P, Felson DT. Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly: The Framingham Study. Am J Epidemiol 2002; 156 (11) 1021-1027
    CrossrefPubMedSuche in Google Scholar
  • 2 Srnec JJ, Wagner ER, Rizzo M. Implant arthroplasty for proximal interphalangeal, metacarpophalangeal, and trapeziometacarpal joint degeneration. J Hand Surg Am 2017; 42 (10) 817-825
    CrossrefPubMedSuche in Google Scholar
  • 3 Linscheid RL, Dobyns JH, Beckenbaugh RD. Cooney WP III. Proximal interphalangeal joint arthroplasty with a total joint design. Mayo Clin Proc 1979; 54 (04) 227-240
    PubMedSuche in Google Scholar
  • 4 Chung KC, Ram AN, Shauver MJ. Outcomes of pyrolytic carbon arthroplasty for the proximal interphalangeal joint. Plast Reconstr Surg 2009; 123 (05) 1521-1532
    CrossrefPubMedSuche in Google Scholar
  • 5 Wijk U, Wollmark M, Kopylov P, Tägil M. Outcomes of proximal interphalangeal joint pyrocarbon implants. J Hand Surg Am 2010; 35 (01) 38-43
    CrossrefPubMedSuche in Google Scholar
  • 6 Adkinson JM, Chung KC. Advances in small joint arthroplasty of the hand. Plast Reconstr Surg 2014; 134 (06) 1260-1268
    CrossrefPubMedSuche in Google Scholar
  • 7 Cook SD, Beckenbaugh RD, Redondo J, Popich LS, Klawitter JJ, Linscheid RL. Long-term follow-up of pyrolytic carbon metacarpophalangeal implants. J Bone Joint Surg Am 1999; 81 (05) 635-648
    CrossrefPubMedSuche in Google Scholar
  • 8 Bales JG, Wall LB, Stern PJ. Long-term results of Swanson silicone arthroplasty for proximal interphalangeal joint osteoarthritis. J Hand Surg Am 2014; 39 (03) 455-461
    CrossrefPubMedSuche in Google Scholar
  • 9 Dickson DR, Badge R, Nuttall D. et al. Pyrocarbon metacarpophalangeal joint arthroplasty in noninflammatory arthritis: minimum 5-year follow-up. J Hand Surg Am 2015; 40 (10) 1956-1962
    CrossrefPubMedSuche in Google Scholar
  • 10 Herren DB, Schindele S, Goldhahn J, Simmen BR. Problematic bone fixation with pyrocarbon implants in proximal interphalangeal joint replacement: short-term results. J Hand Surg [Br] 2006; 31 (06) 643-651
    CrossrefPubMedSuche in Google Scholar
  • 11 Tägil M, Geijer M, Abramo A, Kopylov P. Ten years’ experience with a pyrocarbon prosthesis replacing the proximal interphalangeal joint. A prospective clinical and radiographic follow-up. J Hand Surg Eur Vol 2014; 39 (06) 587-595
    CrossrefPubMedSuche in Google Scholar
  • 12 Storey PA, Goddard M, Clegg C, Birks ME, Bostock SH. Pyrocarbon proximal interphalangeal joint arthroplasty: a medium to long term follow-up of a single surgeon series. J Hand Surg Eur Vol 2015; 40 (09) 952-956
    CrossrefPubMedSuche in Google Scholar
  • 13 Sweets TM, Stern PJ. Pyrolytic carbon resurfacing arthroplasty for osteoarthritis of the proximal interphalangeal joint of the finger. J Bone Joint Surg Am 2011; 93 (15) 1417-1425
    CrossrefPubMedSuche in Google Scholar
  • 14 Bravo CJ, Rizzo M, Hormel KB, Beckenbaugh RD. Pyrolytic carbon proximal interphalangeal joint arthroplasty: results with minimum two-year follow-up evaluation. J Hand Surg Am 2007; 32 (01) 1-11
    CrossrefPubMedSuche in Google Scholar
  • 15 Watts AC, Hearnden AJ, Trail IA, Hayton MJ, Nuttall D, Stanley JK. Pyrocarbon proximal interphalangeal joint arthroplasty: minimum two-year follow-up. J Hand Surg Am 2012; 37 (05) 882-888
    CrossrefPubMedSuche in Google Scholar
  • 16 Dickson DR, Nuttall D, Watts AC, Talwalkar SC, Hayton M, Trail IA. Pyrocarbon proximal interphalangeal joint arthroplasty: minimum five-year follow-up. J Hand Surg Am 2015; 40 (11) 2142-2148.e4
    CrossrefPubMedSuche in Google Scholar
  • 17 Chan K, Ayeni O, McKnight L, Ignacy TA, Farrokhyar F, Thoma A. Pyrocarbon versus silicone proximal interphalangeal joint arthroplasty: a systematic review. Plast Reconstr Surg 2013; 131 (01) 114-124
    CrossrefPubMedSuche in Google Scholar
  • 18 Petscavage JM, Ha AS, Chew FS. Arthroplasty of the hand: radiographic outcomes of pyrolytic carbon proximal interphalangeal and metacarpophalangeal joint replacements. AJR Am J Roentgenol 2011; 197 (05) 1177-1181
    CrossrefPubMedSuche in Google Scholar
  • 19 Johnstone BR, Fitzgerald M, Smith KR, Currie LJ. Cemented versus uncemented surface replacement arthroplasty of the proximal interphalangeal joint with a mean 5-year follow-up. J Hand Surg Am 2008; 33 (05) 726-732
    CrossrefPubMedSuche in Google Scholar
  • 20 Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240 (02) 205-213
    CrossrefPubMedSuche in Google Scholar
  • 21 Tuttle HG, Stern PJ. Pyrolytic carbon proximal interphalangeal joint resurfacing arthroplasty. J Hand Surg Am 2006; 31 (06) 930-939
    CrossrefPubMedSuche in Google Scholar
  • 22 Wagner ER, Weston JT, Houdek MT, Luo TD, Moran SL, Rizzo M. Medium-term outcomes with pyrocarbon proximal interphalangeal arthroplasty: a study of 170 consecutive arthroplasties. J Hand Surg Am 2018; 43 (09) 797-805
    CrossrefPubMedSuche in Google Scholar
  • 23 Lans J, Notermans BJW, Germawi L, Lee H, Jupiter JB, Chen NC. Factors associated with reoperation after silicone proximal interphalangeal joint arthroplasty. Hand (N Y) 2019;
    CrossrefPubMedSuche in Google Scholar
  • 24 Centers for Medicare and Medicaid Services. Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule. Available at: https://www.cms.gov/medicaremedicare-fee-service-paymentdmeposfeescheddmepos-fee-schedule/dme20. Accessed March 3, 2020
    PubMed
  • 25 Nunley RM, Boyer MI, Goldfarb CA. Pyrolytic carbon arthroplasty for posttraumatic arthritis of the proximal interphalangeal joint. J Hand Surg Am 2006; 31 (09) 1468-1474
    CrossrefPubMedSuche in Google Scholar
  • 26 Milone MT, Klifto CS, Hacquebord JH. Prosthetic arthroplasty of proximal interphalangeal joints for treatment of osteoarthritis and posttraumatic arthritis: systematic review and meta-analysis comparing the three ulnar digits with the index finger. Hand (N Y) 2018; 2: 1558 944718791186
    PubMedSuche in Google Scholar
  • 27 Desai A, Gould FJ, Mackay DC. Outcome of pyrocarbon proximal interphalangeal joint replacement. Hand Surg 2014; 19 (01) 77-83
    CrossrefPubMedSuche in Google Scholar
  • 28 Pritsch T, Rizzo M. Reoperations following proximal interphalangeal joint nonconstrained arthroplasties. J Hand Surg Am 2011; 36 (09) 1460-1466
    CrossrefPubMedSuche in Google Scholar
  • 29 Daecke W, Kaszap B, Martini AK, Hagena FW, Rieck B, Jung M. A prospective, randomized comparison of 3 types of proximal interphalangeal joint arthroplasty. J Hand Surg Am 2012; 37 (09) 1770-1779
    CrossrefPubMedSuche in Google Scholar