Journal article

Publication year: 2020

Pages: 445-450

Journal: Surgical Infections

Volume number: 21

Issue number: 5

ISSN: 1096-2964

eISSN: 1557-8674

DOI Link: https://doi.org/10.1089/sur.2019.145

Publisher: Mary Ann Liebert

Abstract: 

Background: Endoprosthetic treatment of finger joints is an established procedure. However, data on peri-prosthetic finger joint infections (PJI) are rare. The goal of this retrospective study was to assess infection rates and treatment outcomes after PJI of the finger joints.

Methods: Between 1984 and 2014, 1,195 finger joints (978 metacarpal and 217 proximal interphalangeal [PIP] joints) in 518 patients were treated. A retrospective record analysis was conducted. Besides demographic data, infection rates, types of revision surgery, and treatment outcomes were evaluated. Treatment strategies changed during the treatment period. Routinely assessed patient-reported outcome measures, namely the QuickDASH score, visual analogue scale (VAS), an everyday function score (activities of daily living; ADL), and an adapted Clayton score, were compared.

Results: In 36 finger joints of 30 patients, a post-operative peri-prosthetic infection could be identified (3%). Infections occurred on average 3.8 years after arthroplasty. For meta-carpal phalangeal (MCP) joints, the best clinical outcomes could be observed after a two-stage revision procedure (QuickDASH score 86). Arthrodesis performed in a one-stage procedure achieved favorable outcomes in PIP joints (QuickDASH score 89). Re-infection mandating revision surgery occurred in seven joints in five patients (7/36; 19.4%). In 25 patients with 29 finger joints, there was no re-infection and no need for revision.

Conclusion: Peri-prosthetic infection of finger joint prostheses occurs in approximately 3% of all cases, which is a higher rate than in the more common hip and knee procedures. For MCP joint revision surgery, a two-stage procedure seems to be the best treatment choice. For PIP joint revision, a single-stage revision with arthrodesis in a functional position achieves a good outcome.

Harvard Citation style: Biehl, C., Rupp, M., Alt, V., Heiss, C., El Khasswana, T. and Szalay, G. (2020) Peri-Prosthetic Joint Infection after Finger Joint Arthroplasty, Surgical Infections, 21(5), pp. 445-450. https://doi.org/10.1089/sur.2019.145

APA Citation style: Biehl, C., Rupp, M., Alt, V., Heiss, C., El Khasswana, T., & Szalay, G. (2020). Peri-Prosthetic Joint Infection after Finger Joint Arthroplasty. Surgical Infections. 21(5), 445-450. https://doi.org/10.1089/sur.2019.145