Results of Toccata® resurfacing PIP joint arthroplasty. A series of 32 cases at a mean follow-up of 5.9 years.

The objective of this study was to evaluate the long-term results of proximal interphalangeal (PIP) resurfacing arthroplasty for treating osteoarthritis: the PIP Toccata implant®. This was a retrospective study of 32 out of 33 PIP arthroplasty cases performed with a dorsolateral or a Chamay approach by two surgeons after a minimum follow-up of 24 months. Patients were reviewed using a standardized assessment of pain, function, mobility and radiological changes. The average follow-up was 5.9 years. The mean active range of motion was 67° (15-95). Radiographic analysis found osteointegration of the implant in all patients except one, in whom distal migration had no clinical consequence. Heterotopic ossifications (HO) developed in 10 of the 20 cases where the implant was inserted through a lateral approach. Intra-articular bone debris was identified in the first postoperative X-ray in most of these cases. The presence of HO was significantly correlated with decreased range of motion (P<0.05). Six patients required surgical revision and two needed implant removal and arthrodesis. Our results are comparable to other published studies of PIP resurfacing arthroplasty. It is important to remove all bone debris when using the dorsolateral approach. The PIP Toccata® implant is a reliable solution for treating PIP osteoarthritis but this arthroplasty procedure is demanding.