Our Summary

This research paper is about different techniques used for a specific type of joint surgery known as Proximal Interphalangeal Joint (PIPJ) arthrodesis, which is often used as a last resort for severe joint disease. The authors looked at a variety of methods, including screws, wires, tension bands, and plate fixation, to see if any one technique was better than the others.

They reviewed existing studies and compared the time it took for the joint to fuse, the rate of unsuccessful fusion (known as nonunion), and the rate of complications for each technique. They found that the time it took for the joint to fuse was similar across all methods. The rate of nonunion was also similar, except that using screws resulted in a lower nonunion rate than using wires. The rate of complications was also similar across techniques.

The authors concluded that all techniques had similar outcomes, but noted that the existing data has significant limitations and suggested more research to better understand any differences between the methods.

FAQs

  1. What is Proximal Interphalangeal Joint (PIPJ) arthrodesis?
  2. Did the research find any technique to be superior in terms of time taken for the joint to fuse or the rate of complications?
  3. What was the difference in the rate of nonunion between using screws and wires in PIPJ arthrodesis?

Doctor’s Tip

One helpful tip a doctor might give a patient about joint fusion is to follow post-operative instructions closely, including taking prescribed medications, attending physical therapy sessions, and avoiding putting too much stress on the fused joint during the healing process. This can help ensure a successful fusion and minimize the risk of complications.

Suitable For

Patients who are typically recommended joint fusion include those with severe joint disease or damage that has not responded to conservative treatments such as medication, physical therapy, or injections. Joint fusion may be recommended for patients who have:

  • Severe arthritis or degenerative joint disease
  • Joint instability
  • Failed previous joint surgeries
  • Joint deformities
  • Chronic joint pain and limited range of motion
  • Joint damage due to injury or trauma

Overall, joint fusion is typically considered when other treatment options have been exhausted and the patient’s quality of life is significantly impacted by their joint condition. It is important for patients to discuss the potential risks and benefits of joint fusion with their healthcare provider to determine if it is the right treatment option for them.

Timeline

Before joint fusion, a patient may experience symptoms such as pain, swelling, stiffness, and limited range of motion in the affected joint. They may have tried other treatments such as medication, physical therapy, or injections without success. Eventually, they may be referred to a surgeon for joint fusion surgery.

After joint fusion surgery, the patient will typically go through a period of immobilization and physical therapy to promote healing and regain strength and function in the joint. The fusion process can take several weeks to months, during which the patient will gradually be able to resume normal activities. Over time, the fused joint will become stable and pain-free, but may have some limitations in range of motion compared to before the surgery. With proper care and rehabilitation, most patients can achieve a good outcome and improved quality of life after joint fusion.

What to Ask Your Doctor

  1. What is the success rate of joint fusion using this technique?
  2. What are the potential risks and complications associated with this procedure?
  3. How long will it take for the joint to fuse after surgery?
  4. What is the recovery process like after joint fusion surgery?
  5. Are there any alternative treatments or techniques that could be considered?
  6. How will joint fusion affect my range of motion and overall function in the affected joint?
  7. What type of physical therapy or rehabilitation will be needed after surgery?
  8. How long will I need to be off work or restrict my activities after joint fusion surgery?
  9. Are there any lifestyle changes or modifications that I will need to make after surgery?
  10. How often will follow-up appointments be needed to monitor the progress of the joint fusion?

Reference

Authors: Faulkner H, An V, Lawson RD, Graham DJ, Sivakumar BS. Journal: Hand (N Y). 2023 Jan;18(1):74-79. doi: 10.1177/1558944721998019. Epub 2021 Mar 7. PMID: 33682483