Post-Operative Rehabilitation After PIP Joint Arthroplasty with Early Active Motion: A Retrospective Review of Outcomes

Abstract

We present a retrospective review of outcomes of the first 15 patients who underwent proximal interphalangeal (PIP) joint arthroplasty and were treated using the same early active motion rehabilitation regime introduced by the therapy department at Mount Vernon Hospital. The regime utilises early motion of the PIP joint, while protecting the arthroplasty with a small static splint and digit strapping to reduce lateral forces on the joint. The notes of 15 patients were reviewed and their outcomes presented. To evaluate the outcomes in more detail, the patients were divided into three groups according to their diagnostic reason for the procedure (rheumatoid arthritis, osteoarthritis and trauma). The overall mean arc of motion at the PIP joint on discharge from therapy was 54° improved from 28° pre-operatively. The patients with the osteoarthritic PIP joints gained the largest improvement in the PIP joint arc of motion and required the least rehabilitation intervention. Patients with rheumatoid arthritis required intense rehabilitation to gain less overall PIP joint motion, but still reported satisfaction with their outcome. All 15 patients experienced an improvement in their pain level and subjectively reported increased function in their affected hand. Following this retrospective review of cases, the team continue to use this regime for metal and silastic prosthesis, but now routinely provide additional written information pre operatively to assist patients’ understanding of the procedure and the extent of the rehabilitation required.