Massachusetts General Hospital, Boston, USA.
Radboud UMC, Nijmegen, The Netherlands.
Hand (N Y). 2021 Jul;16(4):461-466. doi: 10.1177/1558944719864453. Epub 2019 Aug 6.
Silicone proximal interphalangeal (PIP) joint arthroplasty has a high revision rate. It has been suggested that persistent ulnar deviation and joint instability influence the durability of PIP silicone arthroplasties. The goal of this study was to evaluate what factors are associated with reoperation after silicone PIP arthroplasty. We retrospectively evaluated all adult patients who underwent PIP silicone arthroplasty between 2002 and 2016 at one institutional system for inflammatory-, posttraumatic-, and primary degenerative arthritis. After manual chart review, we included 91 patients who underwent 114 arthroplasties. Fingers operated included 14 index, 41 middle, 38 ring, and 21 small fingers. The overall reoperation rate was 14% (n = 16). Non-Caucasian race ( = .040), smoking ( = .022) and PIP silicone arthroplasty for post-traumatic osteoarthritis ( = .021) were associated with reoperation. The 1-, 5- and 10-year implant survival rates were 87%, 85%, and 85%, respectively. Caution should be exercised when considering PIP silicone arthroplasty of the index finger or in patients with post-traumatic osteoarthritis. It may be worthwhile addressing smoking behavior before pursuing silicone PIP arthroplasty.
硅酮近指间(PIP)关节置换术的返修率较高。有研究表明,持续的尺侧偏斜和关节不稳定会影响 PIP 硅酮关节置换的耐久性。本研究旨在评估哪些因素与 PIP 硅酮关节置换术后的再次手术有关。
我们回顾性评估了 2002 年至 2016 年在一个机构系统中接受 PIP 硅酮关节置换术的所有成人患者,这些患者患有炎症性、创伤后和原发性退行性关节炎。经过手动图表审查,我们纳入了 91 名接受了 114 次关节置换术的患者。接受手术的手指包括 14 个食指、41 个中指、38 个环指和 21 个小指。总的再次手术率为 14%(n=16)。非白种人种族(=.040)、吸烟(=.022)和创伤后骨关节炎的 PIP 硅酮关节置换术(=.021)与再次手术有关。1 年、5 年和 10 年的植入物存活率分别为 87%、85%和 85%。
在考虑食指的 PIP 硅酮关节置换术或在创伤后骨关节炎患者中,应谨慎行事。在进行 PIP 硅酮关节置换术前,可能值得解决吸烟行为。