Small Joint Arthroplasty of the Hand: An Update on Indications, Outcomes, and Complications.

J Am Acad Orthop Surg · Aug 01 2023 · Review

Carlson Strother CR, Moran SL, Rizzo M

From the Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN

Hand & Upper Extremity

SUMMARY — THE REDUCTIONReview updates indications, outcomes, and complications of small joint arthroplasty in the hand, comparing pyrocarbon and silicone implants and revision strategies.
Abstract, as published

Small joint arthroplasty of the hand is a well-established surgery that can preserve motion and provide reliable pain relief, joint preservation, and improvement in hand function. Soft-tissue integrity is critical in patient and implant selection to avoid postoperative joint instability. Although instability is more common in nonconstrained implants such as pyrocarbon, silicone arthroplasty is associated with high rates of late implant fracture and failure with resultant recurrent deformity and instability. Additional complications such as stiffness, extension lag, and intraoperative fractures may be mitigated by alterations in surgical technique and postoperative rehabilitation protocols. Revision arthroplasty with soft-tissue stabilization procedures have reliable outcomes and can avoid conversion to arthrodesis. This article will review the surgical indications, outcomes of small joint arthroplasty in the hand, and common complications and their management.

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