PIP joint replacement (Middle finger): Stryker SR Metal on Poly implant
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This is a detailed step by step instruction through a Middle finger Proximal interphalangeal joint (PIPJ) cemented joint replacement with the Styker SR PIP joint implant via a dorsal ulnar 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.
The procedure can be performed as a day case under local, regional or general anaesthetic and take around 1 hour.
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 MCPJ flexion and straight PIPJs. The patient should achieve their pre-operative range of movement with minimal pain by 6 weeks and at this point should start strengthening exercises. The joint will always appear slightly swollen however the majority of post operative swelling will resolve by 3 months.
Author:Mr Mark Brewster FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham ,UK.