title: Pyrocarbon Proximal Interphalangeal Joint Arthroplasty: Minimum Five-Year Follow-Up.
abstract: OBJECTIVE
  To report the outcomes, complications, and survivorship of pyrocarbon proximal interphalangeal joint arthroplasty at a minimum of 5-year follow-up.
  
  
  METHODS
  A review of 97 implants in 72 consecutive patients from our joint arthroplasty database was undertaken. Patient demographics, complications, further surgery, and implant revision were recorded. Objective outcome was assessed by grip strength, range of motion, and radiological assessment of alignment, loosening, and subsidence. Subjective outcome was assessed by Patient Evaluation Measure; Quick Disabilities of the Arm, Shoulder, and Hand score; and visual analog scores (0, best; 10, worst) for appearance, satisfaction, and pain.
  
  
  RESULTS
  Diagnosis was osteoarthritis in 60 joints, rheumatoid arthritis in 12 joints, psoriatic arthritis in 11 joints, and trauma in 14 joints. The average follow-up was 118 months (range, 60-164 months). The mean arc of motion was 35° (range, 0° to 90°). There was no difference in grip strength between operated and nonoperated side. Of the 97 implants, 36 required additional surgery, of which 14 were revised and 22 required reconstruction around a retained implant. The average Patient Evaluation Measure and Quick Disabilities of the Arm, Shoulder and Hand scores were 33 (range, 10-69) and 35 (range, 0-93), respectively. Mean visual analog scores for pain, satisfaction, and appearance were 2 (range, 0-8), 7 (0-10), and 8 (0-10), respectively. All implants had a lucent line with nearly all classified as either Herren grade 2 or 3. Progressive loosening was seen in 48% of implants. Implant survival as assessed by Kaplan-Meier was 85% at both 5 and 10 years.
  
  
  CONCLUSIONS
  Good pain relief and maintenance of preoperative arc of motion was achieved with no major deterioration over time. Most implant revisions were performed within 24 months of the index procedure. Currently progressive loosening was not translated into revision surgery. Implant revision rate was higher than with other prostheses.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, United Kingdom. Electronic address: davidrdickson@hotmail.com.
authors.forename: David R
authors.initials: DR
authors.lastname: Dickson
authors.affiliation: Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Nuttall
authors.affiliation: Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, United Kingdom.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Watts
authors.affiliation: Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, United Kingdom.
authors.forename: Sumedh C
authors.initials: SC
authors.lastname: Talwalkar
authors.affiliation: Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, United Kingdom.
authors.forename: Mike
authors.initials: M
authors.lastname: Hayton
authors.affiliation: Upper Limb Unit, Wrightington Hospital, Wigan, Lancashire, United Kingdom.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Trail
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050806:Arthroplasty, Replacement, Finger / Q000379:methods*; D002244:Carbon; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: C009139:pyrolytic carbon; D002244:Carbon
keywords: Arthroplasty; outcome; proximal interphalangeal joint; pyrocarbon; pyrolytic carbon