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Modi D, Slevin O, Bhalla H, McCombe DB, Berger AC, Tham SKY. Distal Interphalangeal Joint Arthroplasty: A Narrative Review. J Hand Surg Asian Pac Vol 2023; 28:427-434. [PMID: 37758497 DOI: 10.1142/s2424835523500522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Background: Symptomatic distal interphalangeal (DIP) joint arthritis is frequently treated by arthrodesis, though DIP arthroplasty has been reported as a treatment option since 1977. This study reviews the current evidence on DIP joint arthroplasty for the treatment of arthritis refractory to non-operative management. Methods: A systematic search of PubMed, MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed using the ROBINS-I tool. Results: The search yielded 55 records, of which six studies were included in the narrative review. All the included studies were of level IV evidence (case series or cohort studies). DIP arthroplasty was effective in relieving pain and reducing subsequent dysfunction. The average total arc of motion was 30°-40° but with an extension lag of 10°-15°. The overall complication rate was 15% with a re-operation rate of 8%. Joint instability (incidence of 2.5%) and infection (incidence of 2.1%) were the most common complications, while implant fracture was seen in 1% of cases. Joints that failed after DIP arthroplasty were salvaged by DIP arthrodesis. Conclusions: DIP arthroplasty is an effective treatment for painful arthritis but with a complication rate of 15%. Its main advantage over arthrodesis is the preservation of DIP motion. However, due to the limited high-quality evidence available, its use should be limited to circumstances where there is a desire or vocational need to maintain motion at the DIP joint. Level of Evidence: Level V (Therapeutic).
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Affiliation(s)
- Devam Modi
- Department of Hand, Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
| | - Omer Slevin
- Department of Hand, Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
- Victorian Hand Surgery Associates, Fitzroy, Victoria, Australia
- Orthopedic Department, Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hargun Bhalla
- Department of Hand, Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
| | - David B McCombe
- Department of Hand, Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
- Victorian Hand Surgery Associates, Fitzroy, Victoria, Australia
- Hand and Wrist Biomechanics Laboratory, O'Brien Institute/St Vincent's Institute, Fitzroy, Victoria, Australia
| | - Anthony C Berger
- Department of Hand, Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
- Victorian Hand Surgery Associates, Fitzroy, Victoria, Australia
| | - Stephan K Y Tham
- Department of Hand, Plastic and Reconstructive Surgery, St Vincent's Hospital, Melbourne, Australia
- Victorian Hand Surgery Associates, Fitzroy, Victoria, Australia
- Hand and Wrist Biomechanics Laboratory, O'Brien Institute/St Vincent's Institute, Fitzroy, Victoria, Australia
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Labèr R, Schindele SF. [Differential therapeutic Approaches in the prosthetic Arthroplasty of Finger Joints]. HANDCHIR MIKROCHIR P 2022; 54:205-216. [PMID: 35688428 DOI: 10.1055/a-1759-3416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Degenerative changes of the finger joints often lead to various surgical treatments such as arthrodesis or artificial joint replacement. There are a lot of surgical approaches for surgeons to choose from. The different approaches with their characteristic advantages and disadvantages during surgery and for the postoperative treatment should be selected and applied based on patient-, implant- and aftercare-specific indications. This article presents a short review of possible approaches and associated surgical techniques for finger joint replacement.
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