Proximal interphalangeal joint replacement in patients with arthritis of the hand: A meta-analysis
Authors: Adams, J., Ryall, C., Pandyan, A., Metcalf, C., Stokes, M., Bradley, S. and Warwick, D.J.
Journal: Journal of Bone and Joint Surgery - Series B
Volume: 94 B
Issue: 10
Pages: 1305-1312
ISSN: 0301-620X
DOI: 10.1302/0301-620X.94B10.29035
Abstract:We systematically reviewed all the evidence published in the English language on proximal interphalangeal joint (PIPJ) replacement, to determine its effectiveness on the function of the hand and the associated post-operative complications. Original studies were selected if they reported clinical outcome with a minimum of one year's follow-up. Quality was assessed using the Cowley systematic review criteria modified for finger-joint replacements. Of 319 articles identified, only five were adequately reported according to our quality criteria; there were no randomised controlled trials. PIPJ replacements had a substantial effect size on hand pain of -23.2 (95% confidence interval (CI) -27.3 to -19.1) and grip strength 1.2 (95% CI -10.7 to 13.1), and a small effect on range of movement 0.2 (95% CI -0.4 to 0.8). A dorsal approach was most successful. Post-operative loosening occurred in 10% (95% CI 3 to 30) of ceramic and 12.5% (95% CI 7 to 21) of pyrocarbon replacements. Post-operative complications occurred in 27.8% (95% CI 20 to 37). We conclude that the effectiveness of PIPJ replacement has not been established. Small observational case studies and short-term follow-up, together with insufficient reporting of patient data, functional outcomes and complications, limit the value of current evidence. We recommend that a defined core set of patients, surgical and outcome data for this intervention be routinely and systematically collected within the framework of a joint registry. ©2012 British Editorial Society of Bone and Joint Surgery.
Source: Scopus
Proximal interphalangeal joint replacement in patients with arthritis of the hand: a meta-analysis.
Authors: Adams, J., Ryall, C., Pandyan, A., Metcalf, C., Stokes, M., Bradley, S. and Warwick, D.J.
Journal: J Bone Joint Surg Br
Volume: 94
Issue: 10
Pages: 1305-1312
eISSN: 2044-5377
DOI: 10.1302/0301-620X.94B10.29035
Abstract:We systematically reviewed all the evidence published in the English language on proximal interphalangeal joint (PIPJ) replacement, to determine its effectiveness on the function of the hand and the associated post-operative complications. Original studies were selected if they reported clinical outcome with a minimum of one year's follow-up. Quality was assessed using the Cowley systematic review criteria modified for finger-joint replacements. Of 319 articles identified, only five were adequately reported according to our quality criteria; there were no randomised controlled trials. PIPJ replacements had a substantial effect size on hand pain of -23.2 (95% confidence interval (CI) -27.3 to -19.1) and grip strength 1.2 (95% CI -10.7 to 13.1), and a small effect on range of movement 0.2 (95% CI -0.4 to 0.8). A dorsal approach was most successful. Post-operative loosening occurred in 10% (95% CI 3 to 30) of ceramic and 12.5% (95% CI 7 to 21) of pyrocarbon replacements. Post-operative complications occurred in 27.8% (95% CI 20 to 37). We conclude that the effectiveness of PIPJ replacement has not been established. Small observational case studies and short-term follow-up, together with insufficient reporting of patient data, functional outcomes and complications, limit the value of current evidence. We recommend that a defined core set of patients, surgical and outcome data for this intervention be routinely and systematically collected within the framework of a joint registry.
Source: PubMed
Proximal interphalangeal joint replacement in patients with arthritis of the hand A META-ANALYSIS
Authors: Adams, J., Ryall, C., Pandyan, A., Metcalf, C., Stokes, M., Bradley, S. and Warwick, D.J.
Journal: JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME
Volume: 94B
Issue: 10
Pages: 1305-1312
eISSN: 2044-5377
ISSN: 0301-620X
DOI: 10.1302/0301-620X.94B10.29035
Source: Web of Science (Lite)
Proximal interphalangeal joint replacement in patients with arthritis of the hand: a meta-analysis.
Authors: Adams, J., Ryall, C., Pandyan, A., Metcalf, C., Stokes, M., Bradley, S. and Warwick, D.J.
Journal: The Journal of bone and joint surgery. British volume
Volume: 94
Issue: 10
Pages: 1305-1312
eISSN: 2044-5377
ISSN: 0301-620X
DOI: 10.1302/0301-620x.94b10.29035
Abstract:We systematically reviewed all the evidence published in the English language on proximal interphalangeal joint (PIPJ) replacement, to determine its effectiveness on the function of the hand and the associated post-operative complications. Original studies were selected if they reported clinical outcome with a minimum of one year's follow-up. Quality was assessed using the Cowley systematic review criteria modified for finger-joint replacements. Of 319 articles identified, only five were adequately reported according to our quality criteria; there were no randomised controlled trials. PIPJ replacements had a substantial effect size on hand pain of -23.2 (95% confidence interval (CI) -27.3 to -19.1) and grip strength 1.2 (95% CI -10.7 to 13.1), and a small effect on range of movement 0.2 (95% CI -0.4 to 0.8). A dorsal approach was most successful. Post-operative loosening occurred in 10% (95% CI 3 to 30) of ceramic and 12.5% (95% CI 7 to 21) of pyrocarbon replacements. Post-operative complications occurred in 27.8% (95% CI 20 to 37). We conclude that the effectiveness of PIPJ replacement has not been established. Small observational case studies and short-term follow-up, together with insufficient reporting of patient data, functional outcomes and complications, limit the value of current evidence. We recommend that a defined core set of patients, surgical and outcome data for this intervention be routinely and systematically collected within the framework of a joint registry.
Source: Europe PubMed Central