The CapFlex-PIP prosthesis (KLS Martin Group, Tuttlingen, Germany) shows favorable results in the medium term for surface-replacing arthroplasty of the proximal interphalangeal joint (PIP). At our department, we have been using this implant since 2019 with a dorsal approach to the PIP joint with a central tendon split. During the regular follow-up visits, we have noticed a reduction in the range of motion at the non-operated distal interphalangeal joints (DIP) during the postoperative course. We therefore wanted to evaluate the results of this group of patients with a focus on postoperative DIP active range of motion and total active motion (TAM).
From 2019 to 2020, a total of 29 consecutive CapFlex-PIP prostheses were performed using the mentioned surgical approach. Range of motions and the TAM were registered preoperatively, at 3, and 6 months postoperatively.
No improvement in PIP range of motion was noted (mean 52.4° vs. 60.9° 6 months postoperatively, p = 0.06). But we noted a reduction in DIP range of motion (mean 39.3° vs. 24.9° 6 months postoperatively, p < 0.01). No statistically significant TAM reduction was observed (mean 170.5° vs. 166.2° vs mean, p = 0.2). At the MCP joints, we saw a statistically significant improvement of range of motion (mean 86.72° vs. 94.14° 6 months postoperatively, p = 0.02).
The dorsal approach to the PIP joint is easy and convenient for implant positioning. Our results suggest that this approach may lead to a reduction in DIP range of motion. Prospective studies are required to support the findings of this investigation.
Level of Evidence: Level IV, therapeutic study.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Zurich, BASEC No. 2021–00162 02.February 2021.
Written informed consent was obtained from all individual participants included in this study. Additionally separate written consent was obtained for use of the picture included.
Conflict of interest
Inga S. Besmens, Jan Cirebea, Nora Huber, Sophie Knipper, Vera Beckmann-Fries, and Maurizio Calcagni declare no competing interests.
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Besmens, I.S., Cirebea, J., Huber, N. et al. Effect of surface replacing arthroplasty of the proximal interphalangeal joint using the CapFlex-PIP implant on distal interphalangeal and metacarpophalangeal joint range of motion — preliminary outcomes. Eur J Plast Surg 46, 95–98 (2023). https://doi.org/10.1007/s00238-022-01965-y