TOTAL PROXIMAL INTERPHALANGEAL JOINT ARTHROPLASTY FOR OSTEOARTHRITIS VERSUS RHEUMATOID ARTHRITIS — A SYSTEMATIC REVIEW

Osteoarthritis (OA) and rheumatoid arthritis (RA) of the proximal interphalangeal joints (PIPJ) can be treated with arthroplasty, although the complicated anatomy of the joint makes surgery challenging. Controversy exists regarding outcomes in relation to disease aetiology. This study aims to compare functional outcomes and re-operation rates in these two conditions. The electronic databases MEDLINE, EMBASE, Cochrane database and Google scholar were searched in accordance with PRISMA. The study quality was assessed using the Methodological Index for Non-Randomised Studies (MINOR). A total of 16 studies were reviewed including 506 cases in the OA and 542 in the RA group. Five studies assessed function and patient satisfaction, demonstrating a non-significant improvement in the OA group. Five studies reported re-operation rate; three showing it to be lower in the OA group and two reporting similar rates. This review suggests that those undergoing PIPJ arthroplasty for OA may have a better functional outcome and lower re-operation rate.

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Outcomes of Unconstrained Proximal Interphalangeal Joint Arthroplasty: A Systematic Review

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835521500661 ◽

2021 ◽

Author(s):

Kunal Kulkarni ◽

Nomaan Sheikh ◽

Randeep Aujla ◽

Pip Divall ◽

Joseph Dias

Keyword(s):

Systematic Review ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint

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Complications, reoperations and revisions after proximal interphalangeal joint arthroplasty: a systematic review and meta-analysis

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193418770606 ◽

2018 ◽

Vol 43 (10) ◽

pp. 1066-1075 ◽

Cited By ~ 13

Author(s):

Nicole Forster ◽

Stephan Schindele ◽

Laurent Audigé ◽

Miriam Marks

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint ◽

The Other ◽

Silicone Implants

This systematic review and meta-analysis investigates the prevalence of complications, reoperations (surgeries without implant modifications) and revisions (surgeries with implant modifications) after proximal interphalangeal joint arthroplasty with pyrocarbon, metal-polyethylene and silicone implants. Thirty-four articles investigating 1868 proximal interphalangeal joints were included. Implant-related complications were associated with 14%, 10% and 11% of the pyrocarbon, metal-polyethylene and silicone implants, respectively, yet these rates were not significantly different from one another. Silicone implants showed more finger deviations (3%) and instabilities (2%) compared with the other implants. Reoperations were fewer for silicone arthroplasties (1%) compared with pyrocarbon (7%) and metal-polyethylene implants (10%). The revision rates of 4%, 3% and 2% were similar for pyrocarbon, metal-polyethylene and silicone implants. Our results indicate that silicone implants remain a valuable option for the treatment of stable proximal interphalangeal joints. Surface replacing implants might be better to correct unstable or deviated proximal interphalangeal joints, although they are associated with a higher risk of reoperations.

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Swanson Proximal Interphalangeal Joint Arthroplasty in Patients With Rheumatoid Arthritis

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199709000-00006 ◽

1997 ◽

Vol 342 ◽

pp. 34???37 ◽

Cited By ~ 49

Author(s):

Charles R. Ashworth ◽

Kenneth K. Hansraj ◽

Andrew O. Todd ◽

Kesho M. Dukhram ◽

Edward Ebramzadeh ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint

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A Systematic Review of Different Implants and Approaches for Proximal Interphalangeal Joint Arthroplasty

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000003260 ◽

2017 ◽

Vol 139 (5) ◽

pp. 1139e-1151e ◽

Cited By ~ 19

Author(s):

Michiro Yamamoto ◽

Sunitha Malay ◽

Yuki Fujihara ◽

Lin Zhong ◽

Kevin C. Chung

Keyword(s):

Systematic Review ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint

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Toe-to-Finger Vascularized Joint Transfers for Proximal Interphalangeal Joint Reconstruction: A Systematic Review

Hand ◽

10.1177/1558944720988081 ◽

2021 ◽

pp. 155894472098808

Author(s):

Kiane J. Zhou ◽

David J. Graham ◽

Richard D. Lawson ◽

Brahman S. Sivakumar

Keyword(s):

Systematic Review ◽

Range Of Motion ◽

Functional Outcomes ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Autologous Reconstruction ◽

Active Range Of Motion ◽

Reconstructive Option ◽

Meta Analyses ◽

Extensor Lag

Vascularized joint transfer (VJT) from the proximal interphalangeal joint (PIPJ) of the toe is an attractive reconstructive option in cases of nonsalvageable finger PIPJ but is limited by equivocal functional outcomes. This systematic review aims to provide an update on vascularized toe-to-finger PIPJ transfers, examining functional outcomes, complications, and the latest refinements in operative technique. A systematic review of the available literature was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies examining vascularized toe-to-finger PIPJ transfer for post-traumatic indications were included for analysis. Outcomes assessed included postoperative active range of motion, extension lag, and complications. Thirteen studies examining 210 VJTs were analyzed. Five VJTs experienced microsurgical failure giving an overall survival rate of 97.6%. Average postoperative PIPJ active range of motion (ROM) was 40.3° ± 12.9°, with an average extensor lag of 29° ± 10.5° and mean flexion of 68.9° ± 10.9°. For studies reporting complication outcomes, 59/162 complications were seen. No significant differences were seen between studies published prior to 2013 and after 2013 when comparing digital ROM ( P = .123), flexion ( P = .602), and extensor lag ( P = .280). Studies using a reconstructive algorithm based on prior assessment of the donor toe central slip and recipient finger anatomy had significantly improved ROM outcomes ( P = .013). Although VJT provides a reliable option for autologous reconstruction in posttraumatic joints, it is limited by impaired postoperative ROM. Careful assessment of the donor toe and recipient finger anatomy followed by systematic and meticulous reconstruction may lead to improved functional outcomes.

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Systematic review of the introduction, early phase study and evaluation of pyrocarbon proximal interphalangeal joint arthroplasty

PLoS ONE ◽

10.1371/journal.pone.0257497 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0257497

Author(s):

Paul Welford ◽

Natalie S. Blencowe ◽

Emily Pardington ◽

Conor S. Jones ◽

Jane M. Blazeby ◽

...

Keyword(s):

Systematic Review ◽

Research Ethics ◽

Case Reports ◽

Randomised Trial ◽

Case Series ◽

Proximal Interphalangeal Joint ◽

Joint Arthroplasty ◽

Interphalangeal Joint ◽

Retrospective Cohort Studies ◽

Conflicting Interests

Background In 2002 a pyrocarbon interphalangeal joint implant was granted Food and Drug Administration approval with limited evidence of effectiveness. It is important to understand device use and outcomes since this implant entered clinical practice in order to establish incremental evidence, appropriate study design and reporting. This systematic review summarised and appraised studies reporting pyrocarbon proximal interphalangeal joint arthroplasty. Methods Systematic review of MEDLINE, EMBASE, SCOPUS, Web of Science, BIOSIS, CINAHL and CENTRAL from inception to November 2020. All study designs reporting pyrocarbon proximal interphalangeal joint arthroplasty in humans were included. Data extracted included information about study characteristics, patient selection, regulatory (gaining research ethics approval) and governance issues (reporting of conflicting interests), operator and centre experience, technique description and outcome reporting. Descriptive and narrative summaries were reported. Results From 4316 abstracts, 210 full-text articles were screened. A total of 38 studies and 1434 (1–184) patients were included. These consisted of three case reports, 24 case series, 10 retrospective cohort studies and one randomised trial. Inclusion and exclusion criteria were stated in 25 (66%) studies. Most studies (n = 27, 71%) gained research ethics approval to be conducted. Six studies reported conflicting interests. Experience of operating surgeons was reported in nine (24%) and caseload volume in five studies. There was no consensus about the optimal surgical approach. Technical aspects of implant placement were reported frequently (n = 32) but the detail provided varied widely. Studies reported multiple, heterogenous outcomes. The most commonly reported outcome was range of motion (n = 37). Conclusions This systematic review identified inconsistencies in how studies describing the early use and update of an innovative procedure were reported. Incremental evidence was lacking, risking the implant being adopted without robust evaluation. This review adds to evidence highlighting the need for more rigorous evaluation of how implantable medical devices are used in practice following licencing.

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