Investigation of Squeaking in Pyrolytic Carbon Proximal Interphalangeal Joint Implants

2014 ◽  
Vol 8 (1) ◽  
Author(s):  
Caleb Davis ◽  
Andrew R. Thoreson ◽  
Lawrence Berglund ◽  
Steven L. Moran ◽  
Kai-Nan An ◽  
...  
Keyword(s):  
Fetal Bovine Serum ◽  
Pyrolytic Carbon ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Implant Loosening ◽  
Test Device ◽  
Implant Size ◽  
Pip Joint ◽  
Joint Implants ◽  
Fetal Bovine

One commonly reported complication of pyrolytic carbon arthroplasty at the proximal interphalangeal (PIP) joint is an annoying, painless, squeaking postoperatively. This squeak has been anecdotally associated with implant loosening or impending dislocation. The purpose of this study was to investigate the etiology of this squeaking. Proximal and distal components of the pyrolytic carbon PIP implant were inserted into foam bones and mounted onto an oscillating test device. We evaluated the effect of 96 combinations of load, velocity, contact angle, implant size, lubrication, and displacement amplitude over a total of 300 cycles for each condition. Sound analysis was performed on squeaking conditions. Fourteen conditions resulted in squeaking, all with a sound pattern similar to that noted clinically. Unlubricated, “dry” joints did not squeak. Squeaking most commonly occurred with fetal bovine serum lubrication, at higher loads, and at 0 deg hyperextension. Hyaluronic acid viscosupplementation stopped the squeaking in all cases.

TWO TO FIVE YEAR FOLLOW-UP OF THE LPM CERAMIC COATED PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY

2008 ◽  
Vol 33 (1) ◽  
pp. 38-44 ◽  
Author(s):  
J. FIELD
Keyword(s):  
Clinical Signs ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Pip Joint ◽  
Joint Implants ◽  
Post Traumatic ◽  
Joint Arthroplasties ◽  
Traumatic Arthritis

This paper presents a retrospective series of 20 LPM semi-constrained ceramic coated cobalt chrome proximal interphalangeal joint arthroplasties performed consecutively in 12 patients for arthritis of the proximal interphalangeal joint by a single surgeon between 2000 and 2004. Eleven were performed for osteoarthritis, four for post-traumatic arthritis and five for rheumatoid arthritis. Although 12 joints had an improvement in pain and an increased functional arc of movement, six joints required revision surgery for implant failure at an average of 19 months, with clinical signs of increasing pain, deteriorating motion and radiological signs of implant loosening and subsidence. This rate of revision is higher than in published series for other PIP joint implants and, therefore, close surveillance of all patients with this prosthesis currently in situ is recommended. Use of the prosthesis has ceased in this unit.

Results of Vascularized Joint Transfers from the Foot

1997 ◽  
Vol 22 (4) ◽  
pp. 492-498 ◽  
Author(s):  
G. DAUTEL ◽  
M. MERLE
Keyword(s):  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Indications For Surgery ◽  
Pip Joint ◽  
Prosthetic Implant ◽  
Metatarsophalangeal Joints ◽  
Second Toe ◽  
The Average Range

We report our results in ten cases of vascularized joint transfer to reconstruct the proximal interphalangeal joint (five cases) or metacarpophalangeal joints (five cases). Donor sites were the proximal interphalangeal or the metatarsophalangeal joints of the second toe. Indications for surgery were the need to reconstruct both the growth plate and joint space in children or the impossibility of a conventional prosthetic implant. The average range of motion was 44° for the PIP joint and 53° for the MP joint at a mean follow-up of 22.7 months.

A NOVEL ARTIFICIAL PROSTHETIC REPLACEMENT FOR THE PROXIMAL INTERPHALANGEAL JOINT OF THE HAND — FROM CONCEPT TO PROTOTYPE

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 159-168 ◽  
Author(s):  
S. P. Chow ◽  
K. W. Lam ◽  
I. Gibson ◽  
A. H. W. Ngan ◽  
W. Lu ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Prosthesis ◽  
Prosthetic Replacement ◽  
Optimal Range ◽  
Alloy Material ◽  
Pip Joint ◽  
Cobalt Chrome Alloy ◽  
Cobalt Chrome

This article describes the development of a proximal interphalangeal (PIP) joint prosthesis based on the principles of replicating anatomical surface components, the use of macrolocking intramedullary stem and the use of a cobalt-chrome alloy material. The design features are intended to obtain an optimal range of motion while retaining stability and longevity. The final prototype, for which a patent has been filed, is described.

The extensor tendon splitting approach to the proximal interphalangeal joint: do we need to reinsert the central slip?

2009 ◽  
Vol 35 (3) ◽  
pp. 188-191 ◽  
Author(s):  
A. M. Afifi ◽  
A. Richards ◽  
A. Medoro ◽  
D. Mercer ◽  
M. Moneim
Keyword(s):  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Dorsal Approach ◽  
Pip Joint ◽  
Central Slip ◽  
Extensor Lag

Current approaches to the proximal interphalangeal (PIP) joint have potential complications and limitations. We present a dorsal approach that involves splitting the extensor tendon in the midline, detaching the insertion of the central slip and repairing the extensor tendon without reinserting the tendon into the base of the middle phalanx. A retrospective review of 16 digits that had the approach for a PIP joint arthroplasty with a mean follow up of 23 months found a postoperative PIP active ROM of 61° (range 25–90°). Fourteen digits had no extensor lag, while two digits had an extensor lag of 20° and 25°. This modified approach is fast and simple and does not cause an extensor lag.

The Treatment of Chronic Flexion Contractures of the Proximal Interphalangeal Joint

1995 ◽  
Vol 20 (3) ◽  
pp. 385-389 ◽  
Author(s):  
G. ABBIATI ◽  
G. DELARIA ◽  
E. SAPORITI ◽  
M. PETROLATI ◽  
C. TREMOLADA
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Extension Deficit ◽  
Flexion Contractures ◽  
Complete Extension ◽  
Pip Joint ◽  
Surgical Release

A method of treatment of chronic flexion contractures of the PIP joint is presented, with the results obtained in 19 patients treated between 1989 and 1992 after a follow-up of from 6 to 53 months. The flexion contractures, with an extension deficit which ranged between 70 and 90°, had been present for a period of between 2 months and 24 years. Our treatment program involves the surgical release of the unreducible PIP joint followed by the use of static and/or dynamic splints. Surgery is performed using a midlateral approach; the accessory collateral ligament and the flexor sheath are incised and, after the volar plate and check-rein ligaments have been excised, forced hyperextension is applied. The main collateral ligaments are carefully spared and freed from the condyle if there are any remaining adhesions. In our 19 patients, complete extension of the finger was achieved in 11 cases (57.9%); in the remaining 8 cases (42.1%) the residual extension deficit ranges from 10 to 15°. In our experience this combined surgical and rehabilitative approach had led to consistently good results with minimal complications.

A Conservative Approach for Proximal Interphalangeal Joint Arthroplasty

2001 ◽  
Vol 26 (3) ◽  
pp. 235-237 ◽  
Author(s):  
N. R. FAHMY ◽  
A. LAVENDER ◽  
C. BREW
Keyword(s):  
Proximal Phalanx ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Extensor Mechanism ◽  
Conservative Approach ◽  
Lateral Band ◽  
Pip Joint ◽  
Central Slip

Access to the proximal interphalangeal joint of the finger for arthroplasty is difficult without detaching its stabilizers or dividing the tendons that cross it, which then require repair and slow rehabilitation. We describe a method that conserves both, so facilitating post-operative rehabilitation. A C-shaped incision is made on the dorsum of the finger. The lateral bands of the extensor expansion are separated from the central slip proximally to the extensor hood. They are then retracted to expose the condyles of the proximal phalanx, which are excised. The PIP joint is then dislocated between the central slip and a lateral band allowing the remainder of the head to be excised. The middle and proximal phalanges are then prepared to accept the prosthesis. The prosthesis is then inserted and the joint is reduced. The lateral bands of the extensor mechanism are sutured back to the central slip before the skin is closed.

Pyrolytic carbon arthroplasty for the proximal interphalangeal joint: results after minimum 3 years of follow-up

2012 ◽  
Vol 37 (6) ◽  
pp. 501-505 ◽  
Author(s):  
S. A. Mashhadi ◽  
L. Chandrasekharan ◽  
M. A. Pickford
Keyword(s):  
Range Of Motion ◽  
Statistical Significance ◽  
Objective Assessment ◽  
Pyrolytic Carbon ◽  
Proximal Interphalangeal Joint ◽  
Consecutive Series ◽  
Modest Improvement ◽  
Replacement Arthroplasty ◽  
Pip Joint

A retrospective study was undertaken to review the outcomes of a consecutive series of patients treated using pyrocarbon surface replacement arthroplasty by the same surgeon. We analyzed the results of this procedure in 24 proximal interphalangeal (PIP) joints in 19 hands of 16 patients. The minimum follow-up was 3 years. The study showed that pyrocarbon PIP joint replacements provided excellent pain relief and high patient satisfaction. More than two-thirds of patients subjectively rated postoperative range of motion and functional outcomes as better than preoperatively. Objective assessment showed a modest improvement in the active range of motion, which did not achieve statistical significance, although we did observe a statistically significant increase in passive range of motion. The results are encouraging for those surgeons who seek an alternative to silicone implant PIP joint arthroplasty in high-demand patients.

TREATMENT OF CHRONIC POST-TRAUMATIC HYPEREXTENSION DEFORMITY OF PROXIMAL INTERPHALANGEAL JOINT USING THE SUTURE ANCHOR: A CASE REPORT

Hand Surgery ◽  
2007 ◽  
Vol 12 (01) ◽  
pp. 47-49 ◽  
Author(s):  
Yasuo Onishi ◽  
Hiroyuki Fujioka ◽  
Minoru Doita
Keyword(s):  
Suture Anchor ◽  
Proximal Phalanx ◽  
Attachment Site ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Suture Anchors ◽  
Acceptable Result ◽  
Pip Joint ◽  
Post Traumatic ◽  
Little Finger

We present a case of chronic post-traumatic hyperextension of the PIP joint of the little finger. The volar plate was reattached at the original attachment site of the proximal phalanx using two suture anchors and tenodesis of the radial half slip of the FDS tendon was added. An acceptable result was obtained.

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