Travmatologiâ i Ortopediâ Rossii (Mar 2025)
Revision Interventions for Failed Proximal Interphalangeal Joint Arthroplasty: Causes and Outcomes
Abstract
Background. In recent decades, interest in proximal interphalangeal joint (PIPJ) arthroplasty has significantly increased around the world. At the same time, a growing number of operations entail an increase in the number of reinterventions. The aim of the study — to determine the causes and evaluate the outcomes of revision interventions for proximal interphalangeal joint arthroplasty based on the data from a federal center for trauma and orthopedics. Methods. We analyzed gender and age distribution of patients, the number of revisions, possible causes of implant failure, its localization and type, survival rate of the construct, surgical approaches. The study covers a 15-year period. Results. Among 95 performed primary PIPJ arthroplasties, 15 (15.8%) cases of failure were observed in 14 patients. There was 1 periprosthetic fracture; 2 cases of implant fracture; instability of implant components — 12 cases associated with injury, increased physical activity and other causative factors. The maximum failure rate was detected in the II finger (31.6% of the number of initially implanted prostheses). After primary arthroplasty, instability was most often observed in hinged implants (SBI D.G.T. PIP joint implant and the RM Finger Mathys). The option for reintervention in 2 (16.7%) cases was PIPJ arthrodesis, in 11 (83.3%) — revision arthroplasty. Conclusions. Despite the significant (15.8%) rate of adverse outcomes after proximal interphalangeal joint arthroplasty, most frequently caused by implant instability, the survival rate of the implants reaches up to 10 years in some cases and depends both on the type of prosthesis and the patient’s occupation. Overall, revision proximal interphalangeal joint arthroplasty allows for joint mobility preservation and statistically significantly reduces pain.
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