Proximal interphalangeal joint arthroplasty with the Tactys® prosthesis: Clinical and radiological outcomes at a mean 3.1 years' follow-up

Proximal interphalangeal joint arthroplasty: current trends and evidence-based practice

Arthroplasty of the proximal interphalangeal joint (PIPJ) has evolved since its inception over 60 years ago. This review examines the indications for surgery, highlights the differences in current arthroplasty designs, variances in surgical techniques, clinical controversies, current implant outcomes data and salvage options for the failed implant. Overall, PIPJ implant arthroplasty is a good and reliable option for symptomatic PIPJ degenerative, post-traumatic or inflammatory arthritis given the proper clinical setting. If current techniques for implantation and rehabilitation are followed, predictable pain relief and satisfactory function can be anticipated. The purpose of this review article is to examine the current evidence-based indications for PIPJ arthroplasty and examine the reported, implant-specific outcomes of this procedure. Various techniques and rehabilitation strategies will also be outlined.

Functional and radiographic analysis of a cohort of 48 Tactys® prostheses with an average follow-up of 5 years: A retrospective study

OBJECTIVES

The Tactys® prosthesis is an anatomical unconstrained sliding implant with 4 modular components, designed for proximal interphalangeal arthroplasty. The main objective of our study was to evaluate medium-term functional outcomes at a minimum follow-up of 1 year.

MATERIALS AND METHODS

Forty-eight implants were studied, with a mean follow-up of 4.8 years. The study retrospectively analyzed functional, clinical and radiological results. Complications and re-interventions were also analyzed.

RESULTS

Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient-Rated Wrist Evaluation (PRWE) scores improved from 40.9 to 17.7 and from 47. 1 to 11 .2, respectively (p < 0.001) at last follow-up. Seventy-seven percent of patients rated their results as good or very good, and 83% were willing to undergo the procedure again. Pain on VAS improved significantly from 7.9 to 0.8/10 (p < 0.001). There was no significant difference in range of motion (53° vs 48°), grip strength (14.9 kgF vs 14.6 kgF), or pinch strength (3.4 kgF vs 3.4 kgF). There were no cases of fracture or loosening of implants. Periarticular ossification without functional impairment was observed in 31 patients. Axial deviation was generally corrected. Three surgical re-interventions were required, including 2 implant revisions using a silicone spacer. Five-year implant survival was 94%.

CONCLUSION

The Tactys® prosthesis was a reliable and effective option for the management of proximal interphalangeal osteoarthritis. Patient satisfaction was generally good, with improvement in pain and function; however, longer-term follow-up is needed.

Proximal interphalangeal joint prosthetic arthroplasty

Surgical treatment of the painful proximal interphalangeal (PIP) joint has evolved considerably over the past century. If arthrodesis has long been the gold standard and remains so for some, prosthesis would meet patient demand: mobility and indolence. Faced with a demanding patient, the surgeon must decide the indication, the type of prosthesis, the approach, the post-operative follow-up, etc. The history of the development of PIP prostheses demonstrates the complexity of the treatment of the destroyed PIP: appearance of prostheses, evolution and sometimes disappearance from the market for commercial reasons or related to complications. The main objective of this conference is to identify the main indications for prosthetic arthroplasties and to describe the various prostheses available on the market.