title: Silicone proximal interphalangeal joint arthroplasty for primary osteoarthritis using a volar approach.
abstract: OBJECTIVE
  To evaluate the short-term clinical and radiographic outcome of a silicone proximal interphalangeal (PIP) joint implant using a volar approach in patients with primary osteoarthritis.
  
  
  METHODS
  We retrospectively reviewed 36 proximal PIP joints that were replaced with Avanta silicone implants in 26 patients. Inclusion criteria were diagnosis of primary osteoarthrtitis of the PIP joint and failure to respond to conservative treatment. Clinical asessment included range of motion, patient satisfaction, and pain scores. The Quick-Disabilities of the Arm, Shoulder, and Hand questionnaire was administered at final follow-up. Radiographs were reviewed for alignment and implant fracture. Complications were also recorded.
  
  
  RESULTS
  After an average follow-up of 18 months (range, 12-60 mo), pain relief was markedly reduced in all patients, decreasing from a mean score of 7.2 preoperatively to 0.4 postoperatively. The arc of active motion of the PIP joint improved from 33° to 72°. Satisfaction averaged 4.8 on a 5-point Likert scale, and all patients stated they would repeat the surgery. The median final average Quick-Disabilities of the Arm, Shoulder, and Hand score was 7 (range, 4-12). Radiograph review showed 2 implant fractures at 1 and 2 years after surgery, respectively, but without clinical changes. The average deformity in the coronal plane changed from 12° (range, 8° to 18°) preoperatively to 4° (range, 3° to 8°) postoperatively, whereas the average flexion contracture changed from 18° (range, 10° to 30°) to 0° (all patients achieved full active extension). No other complications were observed. No revision surgery has been needed to date.
  
  
  CONCLUSIONS
  The volar approach to PIP joint silicone arthroplasty offers the advantages of maintaining the integrity of the extensor mechanism, providing pain relief, and improving postoperative range of motion with minimal complications. However, further research is needed to determine the long-term efficacy of this implant.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Hand Unit, Orthopaedic Department, Hospital Sant Pau, Barcelona, Spain. Electronic address: iproubasta@santpau.cat.
authors.forename: Ignacio R
authors.initials: IR
authors.lastname: Proubasta
authors.affiliation: Hand Unit, Orthopaedic Department, Hospital Sant Pau, Barcelona, Spain.
authors.forename: Claudia G
authors.initials: CG
authors.lastname: Lamas
authors.affiliation: Hand Unit, Orthopaedic Department, Hospital Sant Pau, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Natera
authors.affiliation: Hand Unit, Orthopaedic Department, Hospital Sant Pau, Barcelona, Spain.
authors.forename: Angelica
authors.initials: A
authors.lastname: Millan
mesh_terms: D000328:Adult; D000368:Aged; D050806:Arthroplasty, Replacement, Finger / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012828:Silicones; D016896:Treatment Outcome
chemical_list: D012828:Silicones
keywords: Osteoarthritis; PIP joint; arthroplasty; palmar approach; silicone