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Preliminary Outcomes of a Novel Biologic Proximal Interphalangeal Joint Arthroplasty Technique Using Meniscus Allograft
Naomi Gadinsky, MD
1, Theodore Brown, BS
1, Seena Sebt, BS
2, Stuart Kuschner, MD
1, Ryan J DellaMaggiora, MD
1, Eugene Y Tsai, MD
1, Justin M Koh, MD
1, Meghan C. McCullough, MD, MS
1; David A. Kulber, MD, FACS
3(1)Cedars-Sinai Medical Center, Los Angeles, CA, (2)University of California Riverside, Riverside, CA, (3)Division of Plastic and Reconstructive Surgery, Cedars-Sinai Medical Center, Los Angeles, CA
Introduction: Proximal interphalangeal (PIP) joint arthritis of the hand can cause significant pain, disability, and negative impacts on quality of life. Patients who fail nonoperative treatment historically have turned to arthrodesis or silicone arthroplasty for management of their disease. We have devised a novel biologic joint resurfacing technique using meniscus allograft to alleviate pain, restore motion, and avoid synthetic implant use in patients with arthritis of the PIP joint. The purpose of this study is to report the preliminary outcomes of this technique.
Materials & Methods: A retrospective review was performed of all patients who underwent PIP joint resurfacing arthroplasty with meniscus allograft at our institution between 2014 and 2024. Charts were reviewed to collect demographic and operative data. Outcomes, complications, and satisfaction with the procedure were reviewed at latest follow up.
Results: 35 procedures were performed in 31 patients within our timeframe. This included 24 females and 11 males with a mean age of 65.1 years old (range: 19-87). Procedures were performed on 8 index, 12 middle, 7 ring, and 8 small digits. Average follow-up was 11 months (range: 1-60). At latest follow up, 28 patients (80%) were overall satisfied with the procedure. There were 3 complications (8.5%) including 1 patient requiring steroid injection for painful scarring, 1 sagittal band rupture, and 1 revision surgery for persistent stiffness. 4 patients (11%) experienced significant postoperative stiffness. No infections were observed.
Conclusion: Hand PIP joint resurfacing arthroplasty with meniscus allograft is a novel motion-preserving procedure utilizing biologic tissue and avoiding the inherent complications of synthetic implants. Our early outcomes are favorable, with a majority of patients feeling satisfied with their surgery, and a low complication rate. Further studies will be needed to obtain longer-term data on this procedure.
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