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Old 03-19-2010, 03:33 PM
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mtomaino mtomaino is offline
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Default PIP joint implant arthroplasty versus fusion?

First, the fact that you have good motion is great, but for the index finger, the functional issue is your pain and instability. And, the functional imperative is pain relief and stability. Second, the hemi-hamate arthroplasty was designed to treat the sequelae of fracture-subluxation, and has no role in treating pip joint arthritis and radial collateral ligament incompetence. It is simply not the appropriate operation for your problem.

Because the index finger is most involved in pinch, and less dependent on range of motion for function of the hand, fusion for treatment of painful PIP joint arthritis in the index finger is the "standard" treatment----it provides pain relief and stability. It also avoids the inevitable risk of failure due to the lateral stresses on an implant that accompany pinch.

That having been said, if you are averse to fusion--understandably--there is the option of replacement. This is a "surface" replacement and bears resemblance to a "knee-replacement' design. in your case, you would also require a reconstruction of the radial collateral ligament-----and you'd have to be prepared for this to fail at some point. The key point is that failure would not burn the bridge of performing a fusion as salvage at some point in the future. Frankly, if I were in your shoes, I would probably want to try something before fusion---but I would have to embrace the absence of any guarantee.

I have attached a picture of the implant. The link below brings you to an informative site regarding this type of PIP joint replacement.

http://www.totalsmallbone.com/us/pro...nd/sr_pip.php4
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File Type: jpg sr_pip_lg.jpg (2.4 KB, 0 views)
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