Arthroplasty of the Proximal Interphalangeal Joint with a New Ceramic Implant

Abstract

Background: Treatment of finger joint destruction still remains an unsolved problem in hand surgery. Arthrodesis, which restricts life quality of the patient to a large extent, is often the only therapeutic option. Numerous implants have been tested in the past decades, yet results were never really satisfactory.
Methods: Between May 1999 and December 2000 we operated 15 patients and implanted 16 newly developed total joint replacements made of ceramic (the Moje prosthesis). 13 patients and 14 joint replacements were reexamined and results were evaluated.
Results: Mean time of follow-up was 11.2 months (one to 19.5 months). Active range of motion in the operated proximal interphalangeal joint (p < 0.001) and grip strength compared to the contralateral side (p = 0.011) increased significantly. Evaluation of the postoperative outcome perceived by the patients was measured according to the DASH score and showed a significantly improved function of the hand (p = 0.001).
Conclusion: Our results after total joint replacement using the Moje prosthesis are highly promising. Long-term studies are necessary to confirm our very positive experiences.

Key words

Prosthesis - Moje - Total joint replacement - Finger

References

• 1 Beckenbaugh R D, Linscheid R L. Arthroplasty in the Hand and Wrist. In Green DP (ed). Operative Hand Surgery (3rd ed.). Churchill Livingstone, New York 1993; 143-187
• 2 Flatt A E, Ellison M R. Restoration of rheumatoid finger joint function.  JBJS [Am]. 1972;  54 1317-1322
• 3 Foucher G, Hoang P, Citron N, Merle M, Dury M. Joint reconstruction following trauma: Comparison of microsurgical transfer and conventional methods: A report of 61 cases.  J Hand Surg [Br]. 1986;  11 388-393
• 4 Germann G, Wind G, Harth A. Der DASH- Fragebogen - Ein neues Instrument zur Beurteilung von Behandlungsergebnissen an der oberen Extremität.  Handchir Mikrochir Plast Chir. 1999;  31 149-152
• 5 Higuchi F, Inoue A, Semlitsch M. Metal-on-metal CoCrMo McKee-Farrar total hip arthroplasty: Characteristics from a long-term follow-up study.  Arch Orthop Trauma Surg. 1997;  116 121-124
• 6 Iselin F, Conti E. Long-term results of proximal interphalangeal joint resection arthroplasties with a silicone implant.  J Hand Surg [Am]. 1995;  20 95-97
• 7 Kiefhaber T R, Stern P J, Grood E S. Lateral stability of the proximal interphalangeal joint.  J Hand Surg [Am]. 1986;  11 661-669
• 8 Lang W, Schmidt A, Ishida A, Baumgärtler H. Erfahrungen mit dem alloplastischen Gelenkersatz am Mittelgelenk.  Handchir Mikrochir Plast Chir. 2000;  32 44-50
• 9 Lin H H, Wyrick J D, Stern P J. Proximal interphalangeal joint silicone replacement arthroplasty: Clinical results using an anterior approach.  J Hand Surg [Am]. 1995;  20 123-132
• 10 Mentzel M, Hoss H, Ebinger T, Halder A, Kinzl L, Wachter N J. DIGITOS Fingermittelgelenkprothesen - Zweijahresergebnisse.  Handchir Mikrochir Plast Chir. 2000;  32 347-352
• 11 Pellegrini V D, Burton R I. Osteoarthritis of the proximal interphalangeal joint of the hand: arthroplasty or fusion?.  J Hand Surg [Am]. 1990;  15 194-209
• 12 Rieu J, Goeuriot P. Ceramic composites for biomedical applications.  Clin Mat. 1993;  12 211-217
• 13 Savory K M, Hutchinson D T, Bloebaum R. Materials testing protocol for small joint prostheses.  J Biomed Mater Res. 1994;  28 1209-1219
• 14 Schmidt K, Miehlke R K, Witt K. Stand der Endoprothetik des Fingergrundgelenkes beim Rheumatiker.  Handchir Mikrochir Plast Chir. 1996;  28 254-264
• 15 Willman G. Normen für keramische Implantate.  Keramische Zeitschrift. 1996;  48 306-313