Gelenkersatz am PIP-Gelenk – Oberflächenersatz vs. Silikonspacer

Zusammenfassung

Seit Einführung der ersten Mittelgelenksprothesen vor fast 50 Jahren durch Brannon und Klein ist es zu einer steten Weiterentwicklung der Implantate, der Operationstechniken und damit auch einer breiteren Indikationsstellung gekommen. Außer der primären Mittelgelenksarthrose werden zunehmend auch posttraumatische und chronisch entzündliche Erkrankungen behandelt. Neben den Silikonspacern erfreuen sich die modernen oberflächenersetzenden Implantate einer zunehmenden Beliebtheit. Dieser Artikel soll einen Überblick über die Geschichte und den aktuellen Stand der Mittelgelenksendoprothetik sowie die Ergebnisse der aktuell verfügbaren Implantate geben. Die einzelnen Implantate werden in Hinblick auf klinische Funktion, Revisionsrate aber auch ökonomische Faktoren miteinander verglichen. Technische Aspekte, wie die Zugangswahl und postoperative Nachbehandlung werden ebenso diskutiert. Gesondert wird auf mögliche Komplikationen sowohl bezüglich der Funktion als auch der Schmerzwahrnehmung eingegangen. Mögliche Therapieansätze and Erfahrungen werden vorgestellt.

Abstract

Since the introduction of the first proximal interphalangeal joint (PIP J) arthroplasty by Brannon and Klein fifty years ago, there has been continuous advancement in implant design and surgical techniques, resulting in an expansion of indications. In addition to primary PIP J osteoarthritis, posttraumatic and inflammatory conditions are increasingly being treated. Besides silicon implants, modern surface replacements have become increasingly popular. This article provides an overview of the history and the current state of PIP J arthroplasty and reviews the outcomes of currently available implants. The various implants are compared regarding their clinical function, revision rates, and economic considerations. Technical aspects, including surgical approach selection and postoperative management, are discussed. Possible complications affecting both range of motion and pain perception are addressed separately, and therapeutic solutions are introduced.

Schlüsselwörter

Endoprothese<Handchirurgie - Bouchardarthrose - Silikonspacer - Mittelgelenksprothese

Keywords

CAP-Flex - Bouchard osteoarthrosis - silicone spacer - PIP joint arthroplasty

Publication History

Received: 17 September 2025

Accepted: 11 December 2025

Article published online:
29 January 2026

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