Document Detail


Outcomes of pyrolytic carbon arthroplasty for the proximal interphalangeal joint at 44 months' mean follow-up.
MedLine Citation:
PMID:  22261566     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Short-term results after proximal interphalangeal joint arthroplasty with pyrolytic carbon (pyrocarbon) implant have shown that this implant has high complication rates, but patient satisfaction is high. The authors evaluated the effectiveness of the implant for use in proximal interphalangeal joint at a minimum of 2 years of follow-up.
METHODS: Thirteen consecutive candidates who underwent 21 proximal interphalangeal joint arthroplasty procedures with pyrocarbon implant were evaluated prospectively. Functional measurements and the Michigan Hand Outcomes Questionnaire were administered preoperatively and at 12 months and intermediate term (>2 years) postoperatively. Preoperative and intermediate-term mean data for all functional measures and questionnaire scores were compared.
RESULTS: Thirteen patients were treated, with a mean follow-up of 44 months. Grip strength, key pinch strength, and active arc of motion demonstrated no statistical difference between preoperative and intermediate-term assessment. All domains of the Michigan Hand Outcomes Questionnaire showed improved large effect size at intermediate-term follow-up, especially pain and satisfaction. There were 10 complications in nine joints (complication rate, 42.9 percent). Patients without complications had better functional outcomes; however, there were no statistical differences in questionnaire scores between patients with and without complications, except for pain (p = 0.04).
CONCLUSIONS: Proximal interphalangeal joint arthroplasty with pyrocarbon implant seems to be an effective way of reducing pain without sacrificing active arc of motion. Despite a high complication rate, patients were generally satisfied, especially with pain relief, and complications did not affect patients' satisfaction even when hand function was affected. Further decision-making analysis to compare arthroplasty and fusion for each finger may help surgeons to select the appropriate operative procedures.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Authors:
Shimpei Ono; Melissa J Shauver; Kate W C Chang; Kevin C Chung
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  129     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-01     Completed Date:  2012-06-25     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1139-50     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthroplasty, Replacement, Finger*
Biocompatible Materials*
Carbon*
Female
Finger Joint / surgery*
Follow-Up Studies
Hand Strength
Humans
Joint Prosthesis*
Male
Middle Aged
Osteoarthritis / surgery*
Patient Satisfaction
Prospective Studies
Questionnaires
Range of Motion, Articular
Recovery of Function
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K24 AR053120/AR/NIAMS NIH HHS; K24 AR053120/AR/NIAMS NIH HHS; K24 AR053120-01A2/AR/NIAMS NIH HHS
Chemical
Reg. No./Substance:
0/Biocompatible Materials; 0/pyrolytic carbon; 7440-44-0/Carbon
Comments/Corrections

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