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Outcomes of Proximal Interphalangeal Joint Pyrocarbon Implants.

Wijk, Ulrika; Wollmark, Margareta; Kopylov, Philippe LU and Tägil, Magnus LU (2010) In The Journal of hand surgery 35A. p.38-43
Abstract
PURPOSE: To prospectively register and report the hand function and occupational performance of patients with proximal interphalangeal joint-pyrocarbon arthroplasty, using both objective tests and subjective outcome instruments. METHODS: From 2004 to 2008, 53 joints in 43 patients were reconstructed with a proximal interphalangeal joint-pyrocarbon prosthesis. The patients underwent a rehabilitation program allowing early motion with an extension stop to limit hyperextension. Range of motion, grip strength, and pain (Visual Analog Scale [VAS]) were recorded and the subjective outcome was evaluated using Canadian Occupational Performance Measure (COPM) and Disabilities of the Arm, Shoulder, and Hand score. RESULTS: Seven patients were... (More)
PURPOSE: To prospectively register and report the hand function and occupational performance of patients with proximal interphalangeal joint-pyrocarbon arthroplasty, using both objective tests and subjective outcome instruments. METHODS: From 2004 to 2008, 53 joints in 43 patients were reconstructed with a proximal interphalangeal joint-pyrocarbon prosthesis. The patients underwent a rehabilitation program allowing early motion with an extension stop to limit hyperextension. Range of motion, grip strength, and pain (Visual Analog Scale [VAS]) were recorded and the subjective outcome was evaluated using Canadian Occupational Performance Measure (COPM) and Disabilities of the Arm, Shoulder, and Hand score. RESULTS: Seven patients were reoperated on (2 infections, 2 arthrodesis, 2 tenolysis, and 1 hyperextension). Pain (VAS) at rest improved from 3.1 cm preoperatively to 0.4 cm (p < .001) and pain (VAS) at activity from 6.2 to 2.0 cm (p < .001) at the latest follow-up (mean, 24 months; minimum, 12 months [+/- 2 weeks]). Disabilities of the Arm, Shoulder, and Hand score improved from a median of 39 to 29 (p = .026). The COPM subjective measurement of occupational performance, improved from a median of 4.6 preoperatively to 5.9 (p = .013) at the latest follow-up, and the COPM, measurement of satisfaction improved from a median of 3.8 to 5.9 (p = .002). Range of motion and grip strength were unchanged. CONCLUSIONS: All patients reported decreased pain, and although we found no improvement in range of motion and grip strength, one third of patients reported a clinically significant improvement in occupational performance and satisfaction. A total of 13% of the joints required a secondary surgical procedure. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV. (Less)
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author
organization
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type
Contribution to journal
publication status
published
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in
The Journal of hand surgery
volume
35A
pages
38 - 43
publisher
Elsevier
external identifiers
  • WOS:000277092600008
  • PMID:19931987
  • Scopus:72449205574
ISSN
1531-6564
DOI
10.1016/j.jhsa.2009.08.010
language
English
LU publication?
yes
id
88293070-95ae-4c43-ab30-443bb7a81b1d (old id 1511648)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19931987?dopt=Abstract
date added to LUP
2009-12-07 09:09:36
date last changed
2016-10-28 15:38:47
@misc{88293070-95ae-4c43-ab30-443bb7a81b1d,
  abstract     = {PURPOSE: To prospectively register and report the hand function and occupational performance of patients with proximal interphalangeal joint-pyrocarbon arthroplasty, using both objective tests and subjective outcome instruments. METHODS: From 2004 to 2008, 53 joints in 43 patients were reconstructed with a proximal interphalangeal joint-pyrocarbon prosthesis. The patients underwent a rehabilitation program allowing early motion with an extension stop to limit hyperextension. Range of motion, grip strength, and pain (Visual Analog Scale [VAS]) were recorded and the subjective outcome was evaluated using Canadian Occupational Performance Measure (COPM) and Disabilities of the Arm, Shoulder, and Hand score. RESULTS: Seven patients were reoperated on (2 infections, 2 arthrodesis, 2 tenolysis, and 1 hyperextension). Pain (VAS) at rest improved from 3.1 cm preoperatively to 0.4 cm (p &lt; .001) and pain (VAS) at activity from 6.2 to 2.0 cm (p &lt; .001) at the latest follow-up (mean, 24 months; minimum, 12 months [+/- 2 weeks]). Disabilities of the Arm, Shoulder, and Hand score improved from a median of 39 to 29 (p = .026). The COPM subjective measurement of occupational performance, improved from a median of 4.6 preoperatively to 5.9 (p = .013) at the latest follow-up, and the COPM, measurement of satisfaction improved from a median of 3.8 to 5.9 (p = .002). Range of motion and grip strength were unchanged. CONCLUSIONS: All patients reported decreased pain, and although we found no improvement in range of motion and grip strength, one third of patients reported a clinically significant improvement in occupational performance and satisfaction. A total of 13% of the joints required a secondary surgical procedure. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.},
  author       = {Wijk, Ulrika and Wollmark, Margareta and Kopylov, Philippe and Tägil, Magnus},
  issn         = {1531-6564},
  language     = {eng},
  pages        = {38--43},
  publisher    = {ARRAY(0x98fe888)},
  series       = {The Journal of hand surgery},
  title        = {Outcomes of Proximal Interphalangeal Joint Pyrocarbon Implants.},
  url          = {http://dx.doi.org/10.1016/j.jhsa.2009.08.010},
  volume       = {35A},
  year         = {2010},
}