Abstract
Purpose 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. Type of study/level of evidence Therapeutic III.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1937-1948 |
| Number of pages | 12 |
| Journal | Journal of Hand Surgery |
| Volume | 40 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 1 2015 |
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Keywords
- Arthrodesis
- index finger PIP joint
- osteoarthritis
- posttraumatic arthritis
- prosthetic arthroplasty
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
Cite this
Prosthetic arthroplasty versus arthrodesis for osteoarthritis and posttraumatic arthritis of the index finger proximal interphalangeal joint. / Vitale, Mark A.; Fruth, Kristin M.; Rizzo, Marco; Moran, Steven Lawrence; Kakar, Sanjeev.
In: Journal of Hand Surgery, Vol. 40, No. 10, 01.10.2015, p. 1937-1948.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prosthetic arthroplasty versus arthrodesis for osteoarthritis and posttraumatic arthritis of the index finger proximal interphalangeal joint
AU - Vitale, Mark A.
AU - Fruth, Kristin M.
AU - Rizzo, Marco
AU - Moran, Steven Lawrence
AU - Kakar, Sanjeev
PY - 2015/10/1
Y1 - 2015/10/1
N2 - Purpose 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. Type of study/level of evidence Therapeutic III.
AB - Purpose 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. Type of study/level of evidence Therapeutic III.
KW - Arthrodesis
KW - index finger PIP joint
KW - osteoarthritis
KW - posttraumatic arthritis
KW - prosthetic arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=84942095215&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942095215&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2015.05.021
DO - 10.1016/j.jhsa.2015.05.021
M3 - Article
C2 - 26188383
AN - SCOPUS:84942095215
VL - 40
SP - 1937
EP - 1948
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
SN - 0266-7681
IS - 10
ER -