Management of the capsule in trapeziometacarpal joint implant arthroplasty: resection versus repair.

We compared the effects of capsule resection versus capsule suturing in patients treated with a dual-mobility trapeziometacarpal joint prosthesis. We included 131 patients with capsular resection and 57 patients with repair. The mean scores for pain and the brief Michigan Hand Outcomes Questionnaire were similar between the groups preoperatively and at 6 weeks and 1 year postoperatively. Mean key pinch strength was also similar in both groups before surgery and at 1 year, but higher in the capsular resection than in the suture group at 6 weeks. The incidence of complications reported throughout the 1-year postoperative period was not significantly different between the groups. One implant in the capsular resection group was revised for reasons most likely unrelated to capsule management. We conclude that the capsule can be safely resected during trapeziometacarpal joint implant arthroplasty.Level of evidence: III.

Surface replacing arthroplasty of the proximal interphalangeal joint using the CapFlex-PIP implant: a prospective study with 5-year outcomes.

The purpose of this prospective study was to evaluate the 5-year outcomes in patients after proximal interphalangeal joint arthroplasty using the surface replacing implant, CapFlex-PIP. Ninety-two prosthesis were implanted and 65 patients with 68 implants were available for follow-up. The brief Michigan Hand Outcomes Questionnaire score improved significantly from 45 (SD 15) before surgery to 71 (SD 17) at 5 years. On the numeric rating scale, pain during activities decreased significantly from 6.4 (SD 1.9) to 1.8 (SD 1.9). Range of motion of the joints increased significantly from 45° (SD 21) to 54° (SD 24). An axis deviation of more than 5° was found in 65% of the joints before surgery, but only in 25% at 5 years. Soft tissue reoperations were performed on eight patients. Four out of 92 implants underwent revision for stiffness or implant loosening. In three implants, the distal component migrated without needing revision. Overall, the CapFlex-PIP implant demonstrates favourable medium-term results in surface replacing arthroplasty of the proximal interphalangeal joint.Level of evidence: IV.