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J Hand Surg Am. 2010 Jan;35(1):38-43. doi: 10.1016/j.jhsa.2009.08.010. Epub 2009 Nov 22.

Outcomes of proximal interphalangeal joint pyrocarbon implants.

Author information

  • 1Hand Unit, Department of Orthopedics, Lund University Hospital, Lund, Sweden. ulrika.wijk@gmail.com

Abstract

PURPOSE:

To prospectively register and report the hand function and occupational performance of patients with proximal interphalangeal joint-pyrocarbon arthroplasty, using both objective tests and subjective outcome instruments.

METHODS:

From 2004 to 2008, 53 joints in 43 patients were reconstructed with a proximal interphalangeal joint-pyrocarbon prosthesis. The patients underwent a rehabilitation program allowing early motion with an extension stop to limit hyperextension. Range of motion, grip strength, and pain (Visual Analog Scale [VAS]) were recorded and the subjective outcome was evaluated using Canadian Occupational Performance Measure (COPM) and Disabilities of the Arm, Shoulder, and Hand score.

RESULTS:

Seven patients were reoperated on (2 infections, 2 arthrodesis, 2 tenolysis, and 1 hyperextension). Pain (VAS) at rest improved from 3.1 cm preoperatively to 0.4 cm (p < .001) and pain (VAS) at activity from 6.2 to 2.0 cm (p < .001) at the latest follow-up (mean, 24 months; minimum, 12 months [+/- 2 weeks]). Disabilities of the Arm, Shoulder, and Hand score improved from a median of 39 to 29 (p = .026). The COPM subjective measurement of occupational performance, improved from a median of 4.6 preoperatively to 5.9 (p = .013) at the latest follow-up, and the COPM, measurement of satisfaction improved from a median of 3.8 to 5.9 (p = .002). Range of motion and grip strength were unchanged.

CONCLUSIONS:

All patients reported decreased pain, and although we found no improvement in range of motion and grip strength, one third of patients reported a clinically significant improvement in occupational performance and satisfaction. A total of 13% of the joints required a secondary surgical procedure.

TYPE OF STUDY/LEVEL OF EVIDENCE:

Therapeutic IV.

Copyright 2010. Published by Elsevier Inc.

PMID:
19931987
[PubMed - indexed for MEDLINE]
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