title: [Linked Prosthesis for the Proximal Interphalangeal Joint: 17-Year Long-Term Results].
abstract: OBJECTIVE
  Joint replacement is a widely used procedure to treat painful osteoarthritis of the proximal interphalangeal joint. From 1996 to 1999, 16 patients received 19 hinged, piston-based DIGITOS prostheses in our department. In 2007, the 7-year clinical course of 14 patients (17 devices) was published in this journal. Now 12 of these patients (15 devices) have been followed with an average history of 17 years, and the preoperative data has been compared with the results after 7 and 17 years, respectively.
  
  
  METHODS
  The patients were 10 women and 2 men, whose average age at the time of the preoperative examination was 63 (48-69) years. Replacements were performed on the index (6), middle (6), and ring finger (3). There were 14 idiopathic osteoarthritic changes and 1 posttraumatic osteoarthritic change. Follow-up included a clinical (range of motion in the proximal interphalangeal joint, extension lag, pain) and radiological examination. In addition, the DASH score was obtained and the patients were asked whether or not they would undergo the same surgery again. The results after 7 and 17 years were reviewed for statistically significant differences.
  
  
  RESULTS
  While there were significant changes regarding extension lag and flexion in the first 7 years after replacement of the proximal interphalangeal joint, only minor changes were observed between 7 and 17 years after surgery. While the prosthesis was in its correct position in the first 2 years after implantation, all prostheses exhibited radiolucent lines after 4 years and periprosthetic osteophytes after 5 years. 17 years after surgery, the radiolucent lines had not increased at all and the osteophytes had increased insignificantly compared with the 7-year findings. None of the patients reported pain; all of them said that they would undergo the same surgical procedure again.
  
  
  CONCLUSIONS
  While there were significant clinical and radiological changes in the first 7 years after replacement of the proximal interphalangeal joint by a linked DIGITOS prosthesis, only minor changes were observed between 7 and 17 years after surgery.
authors: Unfallchirurgie, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm.
authors: J
authors: J
authors: Gülke
authors: Unfallchirurgie, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinik Ulm, Ulm.
authors: M
authors: M
authors: Mentzel
authors: Orthopädie, Universität Ulm, Ulm.
authors: D
authors: D
authors: Dornacher
authors: Fakultät für Naturwissenschaften, Dermatologie und Allergologie, Universität Ulm, Ulm.
authors: L
authors: L
authors: Schneider
authors: Klinik für Neurochirurgie, Universitätsklinik Ulm, Ulm.
authors: T
authors: T
authors: Kapapa
authors: Klinik für Handchirurgie, Plastische und Mikrochirurgie, Katharinenhospital, Klinikum Stuttgart, Stuttgart.
authors: N J
authors: NJ
authors: Wachter
mesh_terms: D000368:Aged; D019643:Arthroplasty, Replacement; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D016896:Treatment Outcome