title: Arthrodesis as a salvage for failed proximal interphalangeal joint arthroplasty.
abstract: OBJECTIVE
  To review the rate of fusion, complications, and subjective outcome measures of proximal interphalangeal joint arthrodesis after failed implant arthroplasty.
  
  
  METHODS
  We conducted a retrospective review identifying patients from 1990 to 2009 who underwent proximal interphalangeal joint arthrodesis for implant arthroplasty failure. All types of implants were included. We reviewed clinical notes and radiographs identifying patient history, implant type, revisions before arthrodesis, method of arthrodesis, rate of union, time to union, and complications. We used the Michigan Hand Outcomes Questionnaire to assess patients' function and perceived clinical outcome.
  
  
  RESULTS
  A total of 13 joints in 8 patients (6 female, 2 male) identified with an average clinical follow-up of 6.5 years (range, 1.0-12.3 y) were available for study. The average time from joint replacement to salvage for all implant types was 9.3 years (range, 1.6-32.2 y). Eight of the 13 fingers achieved union. The average time to union was 5.8 months (range, 1-11 mo). Eight of 13 fingers underwent removal of K-wires, tension band, or both. Excluding hardware-related problems, there were 4 additional complications in 4 patients.
  
  
  CONCLUSIONS
  Salvage of failed proximal interphalangeal joint arthroplasty remains a challenging clinical problem. Although achieving solid fusion with arthrodesis is not completely reliable or without complication, patients' subjective and functional outcomes demonstrate fair to good results.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Jones
authors.forename: Duncan B
authors.initials: DB
authors.lastname: Ackerman
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Sammer
authors.forename: Marco
authors.initials: M
authors.lastname: Rizzo
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000150:complications; D001174:Arthrodesis / Q000379:methods*; D050806:Arthroplasty, Replacement, Finger / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011475:Prosthesis Failure; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome