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Proximal Interphalangeal (PIP) Joint Implant Arthroplasty Using a Volar Approach
Proximal interphalangeal (PIP) joint arthroplasty can provide pain-free and functional restoration to the mobility and stability of the joint. In cases with less than 30 degrees of deviation in the coronal plane, silicone implant interposition arthroplasty canbe used. While a dorsal approach is used most frequently, post-operative immobilization of varying amounts of time are required to allow for healing of the extensor mechanism.
Although technically more demanding, the volar approach allows for immediate post-operative rehabilitation. In this case, a 65-year-old patient presented with painful osteoarthritis of the PIP joint of the right index finger, resulting in weakness of pinch and loss of motion. She has had a previous DIP arthrodesis. Plain radiographs revealed coronal deformity without sagittal malalignment, and 10-55 degrees of passive motion. A volar approach was recommended. This video describes the successful reconstruction
of the index PIP joint using silicone implant arthroplasty from a volar approach.
Drs Buterbaugh, Putnam, Fitzpartick, and Stepan debate the merits of LRTI, Suture button suspension arthroplasty, Suture suspension arthroplasty with or without an implant, and arthrodesis for management of thumb CMC arthritis
Hand Fellows from Philadelphia Hand Center, University of Colorado, Mayo Clinic, and Hospital for Special Surgery debate methods for SL reconstruction. 3 Ligament tenodesis, Reduction and Association of SL, Scapholunate internal brace 360, Swivelock SL IL Reconstruction and ANAFAB are also discussed and compared with pearls for each procedure
Thumb carpal metacarpal joint (CMCJ) arthritis is common. Surgical
denervation is an option for symptomatic CMCJ arthritis. Articular branches of
denervation can be performed using a single volar incision. Synovectomy at the CMCJ
can also be performed at the same time. Short recovery period is noted.
