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使用自锁手指关节植入物进行近节指间关节表面置换术的疗效:至少两年随访

Outcomes of Surface Replacement Proximal Interphalangeal Joint Arthroplasty Using the Self Locking Finger Joint Implant: Minimum Two Years Follow-up.

作者信息

Komatsu Issei, Arishima Yoshiya, Shibahashi Hirotomo, Yamaguchi Toshihito, Minamikawa Yoshitaka

机构信息

1 Takatsuki Orthopaedic Hospital, Tokyo, Japan.

2 Kagoshima Red Cross Hospital, Japan.

出版信息

Hand (N Y). 2018 Nov;13(6):637-645. doi: 10.1177/1558944717726136. Epub 2017 Sep 16.

Abstract

BACKGROUND

The Self Locking Finger Joint (SLFJ) implant is a new type of surface replacement implant. The purpose of this study was to evaluate midterm clinical outcomes of the proximal interphalangeal (PIP) arthroplasty with the SLFJ implant.

METHODS

We retrospectively studied 26 PIP joint arthroplasties using the SLFJ implant in 17 patients with osteoarthritis or posttraumatic osteoarthritis. Preoperative and postoperative range of motion, grip strength and key pinch, radiographic findings, and complications were evaluated. The Disabilities of the Arm, Shoulder, and Hand (DASH) score, visual analog scale (VAS) score, course of pain, and patient satisfaction were obtained.

RESULTS

The mean follow-up time was 44 months (range, 24-76 months). The average active PIP joint arc of motion improved from 36° before surgery to 44° after surgery. Grip strength and key pinch showed no statistical difference between preoperative and postoperative assessments. The average DASH score and VAS score improved from 40 to 15 and from 5 to 1, respectively. Overall patient satisfaction was 94%. Ninety percent of implants showed osteointegration, and there were no radiographic signs of migration and loosening. Three joints (12%) showed abnormal heterotopic bone formation. Four joints (15%) had secondary surgery-1 joint needing joint head and socket replacement and 3 joints needing contracture release.

CONCLUSIONS

Our minimum 2 years of follow-up evaluation of the SLFJ implant PIP joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion. The SLFJ implant showed good osteointegration. Further longer-term prospective studies with various types of currently available implants are needed.

摘要

背景

自锁手指关节(SLFJ)植入物是一种新型的表面置换植入物。本研究的目的是评估使用SLFJ植入物进行近端指间关节(PIP)置换术的中期临床疗效。

方法

我们回顾性研究了17例骨关节炎或创伤后骨关节炎患者使用SLFJ植入物进行的26例PIP关节置换术。评估术前和术后关节活动范围、握力和捏力、影像学表现及并发症。获取上肢、肩部和手部功能障碍(DASH)评分、视觉模拟量表(VAS)评分、疼痛病程及患者满意度。

结果

平均随访时间为44个月(范围24 - 76个月)。PIP关节平均主动活动弧度从术前的36°提高到术后的44°。术前和术后握力及捏力评估无统计学差异。平均DASH评分从40分提高到15分,VAS评分从5分提高到1分。总体患者满意度为94%。90%的植入物显示骨整合,无影像学上的移位和松动迹象。3个关节(12%)出现异常异位骨形成。4个关节(15%)接受了二次手术——1个关节需要进行关节头和关节窝置换,3个关节需要进行挛缩松解。

结论

我们对SLFJ植入物PIP关节置换术至少2年的随访评估表明,在维持关节活动范围的同时,疼痛缓解良好,患者总体满意度较高。SLFJ植入物显示出良好的骨整合。需要对各种现有的植入物进行进一步的长期前瞻性研究。

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