Proximal Interphalangeal Joint Arthroplasty Techniques

Degenerative or inflammatory conditions affecting the proximal interphalangeal (PIP) joint of the finger can lead to pain, stiffness and reduced manual function. Arthroplasty offers an alternative to arthrodesis, aiming to restore motion while maintaining stability. Silicone-based hinge implants have been used for decades, offering a constrained design with relatively straightforward implantation and known long-term wear characteristics. Pyrocarbon hemiarthroplasty provides a more anatomical, low-friction bearing surface, yet challenges such as implant subsidence and preservation of soft-tissue balance persist. Metal-on-polymer designs employ cobalt-chromium components articulating against ultra-high-molecular-weight polyethylene (UHMWPE) to achieve improved durability and reduced wear. Recent approaches explore additive manufacturing of patient-specific titanium implants with anatomical geometry, enhancing congruence with native bone. Novel constraint mechanisms, including rolling contact joint (RCJ) designs, seek to replicate the natural kinematics of the PIP joint and to improve tendon excursion. Across these variations, key priorities involve optimising range of motion, minimising wear and preventing instability under functional loads.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Proximal Interphalangeal Joint Arthroplasty Techniques publication trend

The graph below shows the total number of articles in proximal interphalangeal joint arthroplasty techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Arthroplasty: Surgical reconstruction or replacement of a joint to restore function and relieve pain.

Pyrocarbon: A biocompatible, wear-resistant carbon material used in hemiarthroplasties for low-friction articulations.

Ultra-high-molecular-weight polyethylene (UHMWPE): A polymer bearing surface known for high impact strength and resistance to wear in joint prostheses.

Rolling contact joint (RCJ) mechanism: A constraint system allowing two curved surfaces to roll without slipping, replicating natural joint motion.

Finite element analysis (FEA): A computational technique that divides structures into discrete elements to simulate and assess mechanical stresses under load.

References

1. Development and Biomechanical Evaluation of an Anatomical 3D Printing Modularized Proximal Inter-Phalangeal Joint Implant Based on the Computed Tomography Image Reconstructions. International Journal of Bioprinting (2022).
2. Silicone and Pyrocarbon Artificial Finger Joints. Applied Bionics and Biomechanics (2021).
3. Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism. Journal of Orthopaedic Surgery and Research (2019).
4. Performance of additively manufactured Ti6Al4V ELI finger joints: biomechanical testing and evaluation for arthritis management. Materials Testing (2023).
5. In Vitro Wear Testing of a CoCr-UHMWPE Finger Prosthesis with Hydroxyapatite Coated CoCr Stems. Lubricants (2015).
6. Biomechanical comparative finite element analysis between a conventional proximal interphalangeal joint flexible hinge implant and a novel implant design using a rolling contact joint mechanism. Journal of Orthopaedic Surgery and Research (2023).