Patient characteristics, therapy service delivery and patient outcomes following pyrocarbon proximal interphalangeal joint arthroplasty

Abstract

Background/Aim: Studies on likely sociodemographic and pre-surgical determinants of hand function and satisfaction 
following pyrocarbon proximal interphalangeal joint arthroplasty (PPIJA) are scarce. The primary aim of this study was to 
explore the association between pre-surgical sociodemographic and clinical characteristics and post-surgical hand function and
 satisfaction of patients who underwent PPIJA. A secondary aim was to evaluate the effects of the procedure on pain and active range of movement (AROM) using retrospective data and on-site follow-up assessment
Methods: A panel survey of 48 patients (male = 13; female = 35) with median age of 64 years, who had PPIJA between 2001 and
2012, with a total of 61 arthroplasties, was conducted. During follow-up, participants' pain and satisfaction, AROM, and hand 
disability were assessed using the Pain and Satisfaction Questionnaire (PSQ), goniometer, and the Disability of the Shoulder, 
Hand Shoulder (DASH) Questionnaire respectively.
Results: The main reason for surgery amongst participants was joint stiffness (68%) while 33.3% of the participants had a 
repeat surgery. Participants' median satisfaction and DASH scores at final assessment were 3 and 22.55 respectively. Patients 
who underwent arthroplasty once had significantly higher median PSQ scores (p = 0.011) than those who had their surgery r
repeated.  Pain significantly reduced (p < 0.001) while AROM significantly increased (p = 0.001) from pre-operative assessment to final follow-up assessment.
Conclusions: Pyrocarbon arthroplasty improved treatment outcomes regarding pain and joint motion; post-operative 
satisfaction may be associated with patients having a repeat surgery.

Keywords: Pyrolytic carbon, proximal interphalangeal joint replacement, arthritis, treatment outcome