Clinical Example: Avanta proximal interphalangeal joint surface replacement arthroplasty

Small joint arthoplasty has been an ongoing problem of hand surgery.  The delicate and anatomically precise joints of the fingers function within a very narrow tolerance of friction and mechanical balance of bone and soft tissue forces. Historically, flexible (silicone rubber) implants have failed because of implant breakage, erosive reaction to implant wear debris, and inability of flexible implants to provide rotational and lateral stability. 

Surface replacement implant arthroplasty of the finger joints, similar to large joint replacement, appears to be an improvement on previous strategies, as it mimics the normal joint mechanics, stability, and durability.

The implant used in this case is produced by Avanta (www.avanta.org), constructed of titanium and polyethylene surfaces:


 
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This young man had been treated for a rotating blade injury of the ring finger proximal interphalangeal joint. He had gross instability, pain and stiffness. These radiographs are before and after proximal interphalangeal joint reconstruction with the Avanta proximal interphalangeal joint surface replacement implant arthroplasty. 

Lateral view:

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Oblique view:
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Anteroposterior view:
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Intraoperative appearance of the implant in position:
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