164 / 245
164
· DOS Abstracts
Long-term fixation and function of cementless
and cemented Avanta PIP joint arthroplasty. A
randomized clinical RSA study.
Maiken Stilling, Martin Bille Henriksen , Karsten Krøner, Bo Munk, Janni Kjærgaard
Thilleman
Department of Orthopaedics, University Clinic of Hand, Hip and Knee Surgery,
Hospital Unit West; Department of Orthopaedics, Aalborg University Hospital;
Department of Orthopaedics, Aarhus University Hospital; Department of
Orthopaedics, Aarhus University Hospital; Department of Orthopaedics,
University Clinic of Hand, Hip and Knee Surgery, Hospital Unit West
Background:
Long-term follow-up studies with surface-replacement (SR)
proximal interphalangeal (PIP) finger arthroplasty are sparse.
Purpose / Aim of Study:
To compare long-term fixation and function of ce-
mentless (CL) versus cemented (C) Avanta PIP arthroplasty.
Materials and Methods:
In a prospective, randomized, patient- blinded clinical
trial, we included 30 osteoarthritic PIP joints in 30 patients (7 males) at a mean
age of 56 years (34-69). Dorsal Chamay approach, and CL (n=15) or C (n=15)
fixation of SR PIP joint Avanta arthroplasty, was used in 1 of the 4 ulnar fingers.
We present the long-term (7-10 years) follow-up of 23 patients evaluated
with implant migration (RSA), radiographic and functional outcome, and patient
reported pain and satisfaction.
Findings / Results:
The proximal and distal components had similar mean sub-
sidence and mean rotation around the long axis in the two groups (p>0.24). 3
CL and 2 C proximal components, and 1 CL and 2 C components, subsided more
than 1mm. 8 CL and 7 C PIP joints had pronounced periarticular calcifications
but no functional limitation (mean active ROM of 60°). Functional outcome
was similar between groups (p>0.20) with mean active PIP ROM of 46° (range
-9° to 55°), grip strength of 22 kg (sd 10), pinch strength of 1.9 kg (sd 0.9),
Quick-DASH of mean 24 (sd 26), VAS pain at rest of mean 0.6 (sd 1.4), and
VAS pain in loaded activity of 1.7 (sd 2.5). 4 fingers were stiff and 3 were am-
putated. 1 implant broke and was revised with arthrodesis. VAS satisfaction was
7 (sd 3.6). 70% were willing to repeat SR PIP surgery.
Conclusions:
At long-term follow-up functional results, pain relief, and patient
satisfaction with Avanta SR PIP arthroplasty was good. Fixation of CL and C
components were similar, but 35% of components subsided. 65% of patients
had pronounced periarticular calcifications but no functional limitation.
No conflicts of interest reported
115.