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首页> 外文期刊>Journal of Hand Surgery. American Volume >Medium-Term Outcomes With Pyrocarbon Proximal?Interphalangeal Arthroplasty: A Study?of?170?Consecutive Arthroplasties
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Medium-Term Outcomes With Pyrocarbon Proximal?Interphalangeal Arthroplasty: A Study?of?170?Consecutive Arthroplasties

机译：近期蛋白质近端的中期结果？间关节置换术：一项研究？170？连续关节塑料

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PurposeThe purpose of this study was to examine the medium-term outcomes of patients undergoing proximal interphalangeal (PIP) joint arthroplasty using a pyrocarbon implant. MethodsThe study comprised an analysis of 170 PIP joint pyrocarbon arthroplasties in 99 patients with a minimum 2-year clinical follow-up. Diagnoses included inflammatory arthritis (n?= 49), posttraumatic arthritis (n?= 29), and osteoarthritis (n?= 92). Univariate logistic regression and Kaplan-Meier survival analyses were performed. ResultsAt an average follow-up of 6 years (range, 2–14 years), 58 reoperations (34%) were required, including 36 (21%) involving implant revision surgery. The majority of revisions were performed for either dislocations (n?= 16) or pain and stiffness (n?= 14). The 5- and 10-year survival-free of revision surgery rates were 79% and 77%, respectively. The risk for revision surgery was higher in patients with posttraumatic arthritis. There were 15 intraoperative complications involving a fracture and 26 postoperative complications, including 21 dislocations. In unrevised implants, patients had significant improvements in their preoperative to postoperative pain levels, with no change in their PIP joint total arc of motion. At a mean radiographic follow-up of 5.4 years, there were 28% with grade 3+ loosening and 36% with progressive implant instability. Implant loosening or progressive instability was not associated with worse pain or PIP joint total arc of motion. ConclusionsApproximately 1 in 5 PIP joint arthroplasties with a pyrocarbon implant will require revision surgery by 5 years, and 1 in 3 will undergo more than 1 operation. Furthermore, 1 in 4 PIP joint arthroplasties will have grade 3+ radiographic loosening and 1 in 3 will have progressive loosening or subsidence by 5 years. These results are particularly concerning in young patients and those with posttraumatic arthritis. Overall, in patients that do not require revision surgery, pain relief was improved and motion maintained. Type of study/level of evidenceTherapeutic IV.
机译：本研究的目的目的是检查使用聚丙乙烯植入物进行接受近端间骨膜（PIP）关节置换术患者的中期结果。方法研究介绍了99例临床随访的99例患者170例患者170点乳酸吡克亚钯关节塑料。诊断包括炎症性关节炎（n？= 49），创伤性关节炎（n？= 29）和骨关节炎（n？= 92）。单变量失程回归和Kaplan-Meier存活分析进行。结果3年（范围，2-14岁）的平均随访，需要58次重新进展（34％），其中包括36（21％）涉及植入式修订手术。对脱位（N？= 16）或疼痛和刚度进行大部分修订（n？= 14）。 5-10岁的不含修订手术率分别为79％和77％。手术关节炎患者的修复手术风险较高。有15个术中并发症，涉及骨折和26个术后并发症，其中包括21个脱位。在未经发展的植入物中，患者在术后对术后疼痛水平进行了显着改善，其PIP关节总运动弧度没有变化。在5.4岁的平均放射线摄影后续，38％的含量为3级，渐进式植入物不稳定36％。植入物松开或渐进式不稳定性与较差的疼痛或皮点关节总运动弧无关。结论千克连续1中的千克接头关节植入植入物将需要5岁以下的手术，3英寸3英寸将经历超过1。此外，在4个皮点关节关节血管塑造型下将具有3级以上的射线照相松动，1英寸3中将在5年内进行渐进的松动或沉降。这些结果特别是在年轻患者和具有创伤性关节炎的患者中。总体而言，在不需要修正手术的患者中，止痛缓解得到改善和维持运动。 Evidentureprapticic IV的研究类型/水平。

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