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  • Title: Cemented versus uncemented surface replacement arthroplasty of the proximal interphalangeal joint with a mean 5-year follow-up.
    Author: Johnstone BR, Fitzgerald M, Smith KR, Currie LJ.
    Journal: J Hand Surg Am; 2008; 33(5):726-32. PubMed ID: 18590856.
    Abstract:
    PURPOSE: To retrospectively compare the long-term results of cemented and uncemented surface replacement arthroplasties of the proximal interphalangeal (PIP) joint in a single surgeon's experience. METHODS: A cemented prosthesis was used on 18 patients for 27 PIP joints between February 1997 and September 2000. An uncemented prosthesis was used on 18 patients for 21 PIP joints between September 2000 and June 2003. The preoperative and postoperative pain score (0-10) during activities of daily living and the active range of motion for each digit as well as radiographs were assessed. Patients with less than 2 year of follow-up were excluded unless the short follow-up was due to prosthesis removal. Mean follow-up was 5 years. RESULTS: Data were available for 28 patients who collectively received 24 cemented implants and 19 uncemented implants. The average length of follow-up was 4 years for the uncemented group and 6 years for the cemented group. The average pain score decreased by 5.5 units after the operation, and the average arc of motion increased by 13 degrees after the operation. No evidence was found for any association between implant type and postoperative pain and motion measurements. Very strong evidence was found for an association between implant type and subsidence, with 1 cemented implant subsiding compared with 13 uncemented implants. There was no evidence for an association between implant type and joint failure. CONCLUSIONS: There was no difference in the postoperative pain scores or the postoperative arc of motion for the cemented versus the uncemented group. There were significantly more cases with radiologic evidence of loosening in the uncemented group (p < .001). Revision rate was higher in the uncemented group (26%) compared with that of the cemented group (8%), but this was not a significant difference (risk difference, -0.18; 95% confidence interval, -0.040 to 0.05).
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