gms | German Medical Science

Objective: To evaluate the outcomes (range of motion, function, and pain relief) of the semi constrained prosthesis in posttraumatic arthritis.

Methods: A single surgeon performed proximal interphalangeal (PIP) total replacement arthroplasty (TRA) in 3 joints using a dorsal approach. Patients with posttraumatic arthritis or osteoarthritis of the PIP joint were included. Range of motion, pain, satisfaction, postoperative key pinch and grip strength, and Disabilities of the Arm, Shoulder, and Hand questionnaire data were collected. Complications, component integration were noted. Average follow-up was 24 months (range, 6-24 mo).

Results: Total arc of motion averaged 40° before surgery and improved significantly in all patients, for an average postoperative arc of motion of 61°. Grip strength averaged 30 kg in the affected hand and 35 kg in the contralateral hand after surgery. VAS score improved from 5 to 1. Postoperative key pinch strength averaged 6 and 7 kg in ipsilateral and contralateral hands, respectively. The average Disabilities of the Arm, Shoulder, and Hand score after surgery was 14. No coronal plane deformity or postural deformity was observed. Good component integration and range of motion were observed in all joints.

Conclusions: The semi constrained prosthesis to dorsal approach to PIP TRA can result in excellent range of motion, function, pain relief and good satisfaction with minimal complications in patients with osteoarthritis or posttraumatic arthritis. The dorsal approach offers the advantages of wide exposure and allowing early postoperative motion. This case series demonstrates compelling data for a prospective PIP TRA in patients with osteoarthritis and posttraumatic arthritis.