The authors prospectively studied 17 cementless pyrocarbon proximal interphalangeal joint (PIP) prostheses that were implanted into 14 patients. At a mean follow-up of 19 months, pain relief was noted in all patients in addition to improved grip strength. Motion of the PIP joint was minimally altered (averages: 34 degrees preoperatively, 42 degrees postoperatively). Migration of one, or both, components was observed radiographically in 8 joints and abnormal radiolucent lines were evident in 3 more cases. There was a trend toward less PIP motion in cases with implant migration (p=0.052).
The authors of this study raise the question as to whether pyrocarbon is suitable for press fit fixation in combination with early finger rehabilitation. They propose impact bone grafting and delayed rehabilitation as 2 potential means of averting implant migration. Longer follow-up will be important to determine if this potential complication becomes more prevalent over time.
Pyrocarbon, Joint, Replacement, Arthroplasty
Journal of Hand Surgery