Osteotec silicone finger implant (PIP joint replacement) surgical technique
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Learn the Osteotec silicone finger implant (PIP joint replacement) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Osteotec silicone finger implant (PIP joint replacement) surgical procedure.
This is a detailed step by step instruction for a Middle finger Proximal inter-phalangeal joint (PIPJ) replacement with the Osteotec silastic PIP joint implant, uisng a dorsal midline approach.
This is a procedure usually performed for osteoarthritis of the PIPJ with stable collateral ligaments. It can also be performed for post-traumatic or well controlled inflammatory arthritis as long as the bone stock and soft tissue stability can support the joint. As this is a one piece joint replacement a small amount of joint instability can be tolerated pre-operatively compared with 2 component joint replacements.
Following a period of 1 week in plaster cast the patient then starts mobilisation with a Bedford finger splint and is provided with a night resting splint at 30 degrees metacarpal-phalangeal joint (MCPJ) flexion and straight PIPJs. The patient should achieve close to their pre-operative range of movement with minimal pain by 6 weeks and at this point should start strengthening exercises. The joint will always remain enlarged and swollen after the procedure compared to the pre-operative state although the majority of post operative swelling will resolve by 3 months.
The silastic joint replacements will usually last beyond 5 years (see results section for further details). One major advantage of the silastic versus the metal and poly implants is their ease of revision as they are not cemented. Another advantage is that if the implant itself fractures on occasion the digit may still continue to be functional with a silastic implant.
There are a number of small joint replacements manufactured for the hand which are very similar to the Osteotec silastic PIPJ replacement. The wide range of sizes and reamers on one tray however is a significant thing in the hand. This allows the surgeon the ability with a single kit to replace the MCPJ, PIPJ and distal inter-phalangeal joints (DIPJ) and deal effectively with a wide range of phalangeal sizes.
Readers will also find of interest the following techniques on OrthOracle: Stryker SR MCPJ Cemented Joint replacement, PIP joint replacement (Middle finger): Stryker SR Metal on Poly implant, Fractional Tendon Lengthening and Swanson Silastic Metacarpophalangeal Joint Replacement (Wright Medical) for Spasticity
Author – Mr Mark Brewster
Royal Orthopaedic Hospital, Birmingham
Author: Mr Mark Brewster FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
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- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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