Outcomes of proximal interphalangeal joint pyrocarbon implants.
OBJECTIVE
To prospectively register and report the hand function and occupational performance of patients with proximal interphalangeal joint-pyrocarbon arthroplasty, using both objective tests and subjective outcome instruments.


METHODS
From 2004 to 2008, 53 joints in 43 patients were reconstructed with a proximal interphalangeal joint-pyrocarbon prosthesis. The patients underwent a rehabilitation program allowing early motion with an extension stop to limit hyperextension. Range of motion, grip strength, and pain (Visual Analog Scale [VAS]) were recorded and the subjective outcome was evaluated using Canadian Occupational Performance Measure (COPM) and Disabilities of the Arm, Shoulder, and Hand score.


RESULTS
Seven patients were reoperated on (2 infections, 2 arthrodesis, 2 tenolysis, and 1 hyperextension). Pain (VAS) at rest improved from 3.1 cm preoperatively to 0.4 cm (p < .001) and pain (VAS) at activity from 6.2 to 2.0 cm (p < .001) at the latest follow-up (mean, 24 months; minimum, 12 months [+/- 2 weeks]). Disabilities of the Arm, Shoulder, and Hand score improved from a median of 39 to 29 (p = .026). The COPM subjective measurement of occupational performance, improved from a median of 4.6 preoperatively to 5.9 (p = .013) at the latest follow-up, and the COPM, measurement of satisfaction improved from a median of 3.8 to 5.9 (p = .002). Range of motion and grip strength were unchanged.


CONCLUSIONS
All patients reported decreased pain, and although we found no improvement in range of motion and grip strength, one third of patients reported a clinically significant improvement in occupational performance and satisfaction. A total of 13% of the joints required a secondary surgical procedure.


METHODS
Therapeutic IV.
Wijk
Ulrika
U
Hand Unit, Department of Orthopedics, Lund University Hospital, Lund, Sweden. ulrika.wijk@gmail.com
Wollmark
Margareta
M
Kopylov
Philippe
P
Tägil
Magnus
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050806:Arthroplasty, Replacement, Finger / Q000379:methods*; D001672:Biocompatible Materials; D002244:Carbon; D004185:Disability Evaluation; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D001672:Biocompatible Materials; C009139:pyrolytic carbon; D002244:Carbon