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J Hand Microsurg 2021; 13(03): 132-137
DOI: 10.1055/s-0040-1709088
Original Article

Factors Associated with Reoperation after Pyrocarbon Proximal Interphalangeal Joint Arthroplasty for the Arthritic Joint: A Retrospective Cohort Study

Bo J. W. Notermans
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Jonathan Lans 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Ryan P. Ponton
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Jesse B. Jupiter 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
,
Neal C. Chen 
1   Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations Funding None.
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Abstract

Introduction The rate of reoperation after pyrocarbon proximal interphalangeal (PIP) joint arthroplasty ranges from 5.9 to 37% and complications such as radiographic loosening, deformity, dislocation, and stiffness are common. Because of the limited amount of knowledge around these problems, we evaluated factors associated with reoperation after pyrocarbon PIP arthroplasty.

Materials and Methods We retrospectively included all adult patients that underwent primary PIP pyrocarbon implant arthroplasty between 2002 and 2016 at one institutional system. A total of 45 patients, with a mean age of 55 (standard deviation: 14), underwent 66 PIP arthroplasties. To address for within individual correlations, we only included fingers treated at patients’ initial surgery (n = 54) in our statistical analysis. These patients were predominantly diagnosed with noninflammatory arthritis 73% (n = 33). Arthroplasty was performed upon 10 index, 22 middle, 20 ring, and 2 small fingers.

Results The reoperation rate after pyrocarbon PIP arthroplasty was 30% over a median follow-up of 25 months (interquartile range: 8.7–54). Indications for reoperation consisted of subluxation (n = 6), stiffness (n = 5), swan-neck deformity (n = 3), and soft tissue complications (n = 2). Younger age (p = 0.025), male sex (p = 0.017), and noninflammatory arthritis (p = 0.038) were associated with a higher reoperation rate.

Conclusion In this study, our reoperation rate after pyrocarbon PIP arthroplasty was 30%. This study suggested that younger patients, males, and patients with noninflammatory arthritis are at higher risk of reoperation. We recommend considering these factors when selecting candidates for pyrocarbon arthroplasty. Future studies should focus on prospectively researching these factors in comparison with other implants.

Keywords

proximal interphalangeal arthroplasty - pyrocarbon arthroplasty - finger arthroplasty


Publication History

Article published online:
09 April 2020

© 2021. Society of Indian Hand & Microsurgeons. All rights reserved. Thieme Medical and Scientific

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