Arthroplasty of the proximal interphalangeal joint with the TACTYS prosthesis: Preliminary results after a minimum follow-up of 2 years.

The TACTYS implant is a new anatomic gliding articular and modular prosthesis for the proximal interphalangeal (PIP) joint. We report preliminary results with a minimum follow-up of 2 years. Twenty-two patients with a mean age of 63 years were operated on at a single center by two senior hand surgeons. Indications were painful and stiff PIP joints. The joint damage was caused by osteoarthritis (18 cases), post-traumatic arthritis (3) and rheumatoid arthritis (1). All prostheses were implanted through a dorsal mid-line transtendinous approach. Postoperative active and passive range of motion in flexion and extension was performed immediately with a protective splint for 2weeks. All patients were evaluated (pain, range of motion, strength, function, X-rays) with a mean follow-up of 34months (range 24-50). Pain decreased from 6.5 preoperatively to 1.9 postoperatively on a VAS scale. Flexion-extension range of motion increased from 39° preoperatively to 58° postoperatively. Grip strength was 21kg preoperatively and 25kg postoperatively. Pinch strength was 3kg preoperatively and 5kg postoperatively. Functional QuickDASH and PRWE scores were significantly improved at the last follow-up. Four patients were reoperated on: dorsal tenoarthrolysis in 3 cases and volar osteophyte removal in 1 case. All implants were still in place at the last follow-up. On X-rays, there were no signs of implant migration or loosening. The modularity of the prosthesis seems to be this implant's greatest advantage. The TACTYS prosthesis is a reliable alternative to other conventional PIP implants.