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Complications after surface replacing and silicone PIP arthroplasty: an analysis of 703 implants

Abstract

Introduction

The aim was to analyse complications after surface replacing and silicone proximal interphalangeal (PIP) joint arthroplasty.

Materials and methods

All complications, reoperations (subsequent intervention without implant modification) and revisions (subsequent surgery with implant modification or removal) were extracted out of our registry for two cohorts: (1) Patients who received a surface replacing arthroplasty at the PIP joint using the CapFlex-PIP prosthesis and (2) patients who received a PIP silicone implant. Furthermore, radiographs were evaluated for deviations from the longitudinal finger axis.

Results

In our registry, 279 surface replacing implants and 424 silicone implants have been documented. The overall complication rate was 20% for surface replacements and 11% for silicone arthroplasties (p ≤ 0.01) with soft tissue-related events being the most prevalent in both groups. Reoperations were significantly more frequent after surface replacement (5.4%) than silicone arthroplasty (0.5%; p ≤ 0.001), while the revision rates did not differ significantly (4.4% and 3.3%, respectively; p = 0.542). Postoperative axis deviations were significantly less frequent in the surface replacement group (19% versus 58% for silicone arthroplasty; p ≤ 0.001).

Conclusion

We recommend using a surface replacing implant in fingers with preoperative axis deviations and correctable anatomical situation, bearing in mind the higher risk of a second surgery. However, treatment outcomes also need to be considered before choosing one implant over another.

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Acknowledgements

The authors would like to thank Dr. Melissa Wilhelmi (Schulthess Klinik) for the copy-editing of this manuscript and Birgit Steiger (Schulthess Klinik) and Martina Wehrli (Schulthess Klinik) for assistance in data collection.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

Authors

Contributions

OH collected the data. MM analysed the data. OH and MM wrote the first draft of the manuscript. AS, DH and SS supervised the study. All authors were involved in developing the research question, reviewed and edited the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Stephan Schindele.

Ethics declarations

Conflict of interest

S. Schindele and D.B. Herren were involved in the development of the CapFlex implant and receive royalties from KLS Martin Group, Tuttlingen, Germany.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Ethics approval for this data analysis study was obtained from the Cantonal Ethics Committee of Zurich, Switzerland (no. 2014-0546).

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Patients signed informed consent regarding publishing their data.

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Helder, O., Marks, M., Schweizer, A. et al. Complications after surface replacing and silicone PIP arthroplasty: an analysis of 703 implants. Arch Orthop Trauma Surg 141, 173–181 (2021). https://doi.org/10.1007/s00402-020-03663-5

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  • DOI: https://doi.org/10.1007/s00402-020-03663-5

Keywords

  • Adverse event
  • Finger middle joint
  • Implant failure
  • CapFlex arthroplasty
  • Swanson silicone implant