| Proximal interphalangeal joint replacement in patients with arthritis of the hand: A meta-analysis. | |
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MedLine Citation:
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PMID: 23015553 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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We systematically reviewed all the evidence published in the English language on proximal interphalangeal joint (PIPJ) replacement, to determine its effectiveness on the function of the hand and the associated post-operative complications. Original studies were selected if they reported clinical outcome with a minimum of one year's follow-up. Quality was assessed using the Cowley systematic review criteria modified for finger-joint replacements. Of 319 articles identified, only five were adequately reported according to our quality criteria; there were no randomised controlled trials. PIPJ replacements had a substantial effect size on hand pain of -23.2 (95% confidence interval (CI) -27.3 to -19.1) and grip strength 1.2 (95% CI -10.7 to 13.1), and a small effect on range of movement 0.2 (95% CI -0.4 to 0.8). A dorsal approach was most successful. Post-operative loosening occurred in 10% (95% CI 3 to 30) of ceramic and 12.5% (95% CI 7 to 21) of pyrocarbon replacements. Post-operative complications occurred in 27.8% (95% CI 20 to 37). We conclude that the effectiveness of PIPJ replacement has not been established. Small observational case studies and short-term follow-up, together with insufficient reporting of patient data, functional outcomes and complications, limit the value of current evidence. We recommend that a defined core set of patients, surgical and outcome data for this intervention be routinely and systematically collected within the framework of a joint registry. |
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Authors:
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J Adams; C Ryall; A Pandyan; C Metcalf; M Stokes; S Bradley; D J Warwick |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of bone and joint surgery. British volume Volume: 94 ISSN: 0301-620X ISO Abbreviation: J Bone Joint Surg Br Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375355 Medline TA: J Bone Joint Surg Br Country: England |
Other Details:
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Languages: eng Pagination: 1305-12 Citation Subset: AIM; IM |
Affiliation:
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University of Southampton, Faculty of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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