Pyrocarbon Hemiarthroplasty Via Lateral Approach for the Treatment of PIP Osteoarthritis.

Abstract

Hemiarthroplasty of the proximal interphalangeal (PIP) joint using a pyrocarbon implant was initially described for the salvage of nonreconstructable fractures with loss of 1 joint surface. Later, this method was used to treat osteoarthritis. PIP hemiarthroplasty is less invasive than total arthroplasty. The lateral approach to the PIP joint has been described in combination with silicone arthroplasty, offering the advantages of a less demanding surgical preparation and avoiding violation of the extensor mechanism. We present a technique for pyrocarbon PIP hemiarthroplasty through a lateral approach, which is less invasive and allows easier rehabilitation. We operated on 8 fingers in 7 patients with this technique. The active PIP range of motion increased from a mean of 41 to 65 degrees, and the extension deficit decreased from 17 to 9 degrees. The Quick DASH score improved from 64.9 to 20.6, the PRWHE score from 53.6 to 29.6, and the general pain on the VAS scale from 7.4 to 0.8. Hemiarthroplasty through a lateral approach resulted in good pain relief and functional improvement.