Melbourne Hand Surgery 

Coronavirus update: All consultations at Melbourne Hand Surgery are now conducted via telehealth (phone or video consultation), except where we have previously confirmed the requirement for an in-person physical examination or wound care management.  Mr Babazadeh is accepting referrals; Dr Tomlinson is not accepting urgent referrals and is on sabbatical leave. 

Emergency and urgent surgery is currently being conducted in hospitals. We anticipate a return to full elective surgery services from 31 July, in line with Victorian Government directives on the staged recommencement of elective surgery. Out of an abundance of caution we will apply the same approach to the recommencement of elective rooms procedures. 

Our practice will be closed on Fridays until further notice. We will use this website banner to provide general updates on changes to our practice and the availability of non-urgent procedures and surgery in the weeks and months ahead. Thank you for your understanding as our community works through these unprecedented and rapidly evolving times together (last updated: 20 May 2020).

Proximal interphalangeal (PIP) joint replacement surgery

PIPJarthritisfromRadiopaediaDOTorgPIP joint replacement (arthroplasty) can be performed using a

  • Swanson (silicone) joint replacement prosthesis
  • Pyrocarbon joint replacement prosthesis
  • Hemi-hamate [suitable for replacement of half the joint only, in selected early cases of joint injury after trauma]

Pyrocarbon replacements are most commonly performed for osteoarthritis or post-traumatic arthritis. Swanson (silicone) joint replacements are most commonly performed for rheumatoid arthritis.

Results

This surgery is generally effective at relieving arthritic pain in the affected joint and at maintaining movement. The surgery will not restore full movement (or near-full movement) to a stiff joint. For more detail see the "Literature" section below.

Complications

Possible complications include skin infection (cellulitis), bone infection (osteomyelitis), infection of the joint or prosthesis, joint instability, joint stiffness and pain. If the joint replacement fails the usual back-up or salvage treatment is a joint fusion (arthrodesis).

Post operative therapy regimens

Ascension Pyrocarbon PIP joint replacement (dorsal approach)

Literature

 A 2012 study examined the outcomes and complications of patients with PIP joint replacement at a minimum of 2 years of follow-up. The 97 joint replacement surgeries were performed on 72 patients for primary osteoarthritis in 43 patients (60%), posttraumatic arthritis in 14 (19%), rheumatoid arthritis in 9 (13%), and psoriatic arthritis in 6 (8%). Twenty three percent of the joints had repeat surgery without revision, and 13% had revision at an average stage of 15 months after the initial joint replacement. The average pain score was zero (no pain). The conclusion was: "The survival of pyrocarbon PIP joint arthroplasty was 85% (83 of 97) at 5 years of follow-up, with high patient satisfaction. Patients should be advised that the procedure achieves good relief of pain but does not improve range of motion." Reference: Watts AC, Hearnden AJ, Trail IA, Hayton MJ, Nuttall D, Stanley JK. Pyrocarbon Proximal interphalangeal Arthroplasty: Minimum Two-Year Follow-Up. J Hand Surg May 2012 Vol 37:5; p882-888.

 

 

FRACS

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.

Search only trustworthy HONcode health websites: