title: Prosthetic Arthroplasty Versus Arthrodesis for Osteoarthritis and Posttraumatic Arthritis of the Index Finger Proximal Interphalangeal Joint.
abstract: OBJECTIVE
  To compare outcomes of prosthetic arthroplasty versus arthrodesis to treat index finger proximal interphalangeal (PIP) joint arthritis.
  
  
  METHODS
  Patients with osteoarthritis or posttraumatic arthritis of index finger PIP joints were evaluated. Digit range of motion, grip and pinch strength, patient-rated pain and satisfaction scores, Michigan Hand Questionnaire scores, and complications were recorded.
  
  
  RESULTS
  A total of 79 finger PIP joints were followed for a median of 67 months overall (72 months for arthroplasty and 8 months for the arthrodesis group). Sixty-five were treated with arthroplasty and 14 with arthrodesis. Patients undergoing arthroplasty experienced no significant postoperative change in PIP joint range of motion whereas all preoperative PIP joint motion was eliminated after arthrodesis. Patients undergoing arthroplasty experienced significant postoperative improvement in opposition pinch. In contrast, patients undergoing arthrodesis experienced significant improvement in both opposition and apposition pinch. There were no differences in pain relief, satisfaction, or Michigan Hand Questionnaire scores between treatment groups. Patients undergoing arthroplasty had a significantly greater mean number of complications per year and mean number of complications in the first year postoperatively. There was a 4.3 times increased risk of complication in patients undergoing arthroplasty versus arthrodesis, and Kaplan-Meier analysis revealed a shorter time to first complication among patients undergoing arthroplasty.
  
  
  CONCLUSIONS
  The decision for prosthetic arthroplasty versus arthrodesis in the index finger of patients with osteoarthritis or posttraumatic arthritis must be made with patient goals in mind and in light of greater risk of complications associated with arthroplasty.
authors.affiliation: Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Vitale
authors.affiliation: Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Fruth
authors.affiliation: Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Marco
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN; Division of Plastic Surgery, Mayo Clinic, Rochester, MN. Electronic address: moran.steven@mayo.edu.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Moran
authors.affiliation: Division of Hand Surgery, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kakar
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D050806:Arthroplasty, Replacement, Finger / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005384:Finger Joint / Q000503:physiopathology / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D007595:Joint Prosthesis; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000209:etiology / Q000503:physiopathology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications*
keywords: Arthrodesis; index finger PIP joint; osteoarthritis; posttraumatic arthritis; prosthetic arthroplasty