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Proximal Interphalangeal Joint Arthroplasty in Young Patients

Wagner, Eric R., MD, MS; Robinson, William A., MD; Houdek, Matthew T., MD, MS; Moran, Steven L., MD; Rizzo, Marco, MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: June 15, 2019 - Volume 27 - Issue 12 - p 444–450
doi: 10.5435/JAAOS-D-17-00109
Research Article
SDC

Introduction: This investigation compares the outcomes of proximal interphalangeal (PIP) arthroplasty in patients older than and younger than 60 years.

Methods: Overall, 299 consecutive, primary PIP arthroplasties were performed over a 14-year period, including 126 arthroplasties performed in patients younger than 60 years. In younger patients group, a higher rate of posttraumatic and inflammatory arthritis was observed.

Results: In patients younger than 60 years, 32 (25%) revision surgeries occurred. Risk of revision surgery was associated with younger age. The 10-year implant survival rate was 72% for the patients younger than 60 years versus 86% for those older than 60 years. Silicone implants decreased the risk of revision surgery, although it was increased in posttraumatic arthritis. The most common complication in young patients was dislocation (n = 21). At a mean follow-up of 6.4 years, pain levels had significantly improved in patients younger than 60 years, and PIP range of motion and pinch strength were maintained. However, older patients had improved PIP motion compared with younger patients.

Conclusions: Younger age leads higher revision rates after PIP arthroplasty, particularly in the posttraumatic setting.

Level of Evidence: Therapeutic, level III

From the Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN.

Correspondence to Dr. Rizzo: rizzo.marco@mayo.edu

Dr. Moran or an immediate family member has received royalties from Integra; serves as a paid consultant to Integra; has stock or stock options held in Axogen; and serves as a board member, owner, officer, or committee member of American Society for Surgery of the Hand. Dr. Rizzoor an immediate family member serves as a paid consultant to Zimmer Biomet and serves as a board member, owner, officer, or committee member of American Association for Hand Surgery and American Society for Surgery of the Hand. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Wagner, Dr. Robinson, and Dr. Houdek.

© 2019 by American Academy of Orthopaedic Surgeons
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