Journal of Hand Surgery European - 2026-04-07 - Journal Article
Prediction of adverse events in proximal interphalangeal joint surface-replacement implants.
Hornung E, Mathis KH, Marks M, Schweizer A, Herren DB, Schindele S
Topics
Key Takeaway
Greater surgical experience with the CapFlex-PIP prosthesis was associated with an 83% reduced risk of implant-related problems and a 76% reduced risk of revision surgery over up to 10 years.
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Summary
This registry-based study identified predictors of adverse events following PIP joint surface replacement with the CapFlex-PIP prosthesis in 476 implants. Multivariate logistic regression identified younger age and prior hand surgery as risk factors for limited ROM (<30°), while the little finger carried higher risk of implant-related problems. Greater surgical experience independently reduced implant-related problems by 83% and revision risk by 76%, though models explained only 10% of variance in ROM outcomes.
Key Limitation
The models explain only a small proportion of outcome variance (R²=0.10), meaning the identified predictors have limited clinical utility for individual patient risk stratification.
Original Abstract
INTRODUCTION
The aim of this registry-based study was to analyse predictors of adverse events and the risk of implant revision surgery up to 10 years after proximal interphalangeal joint surface replacement.
METHODS
Adverse events in patients who underwent proximal interphalangeal joint surface replacement with the CapFlex-PIP prosthesis between 2010 and 2024 were analysed. Uni- and multivariate logistic regression models were developed to identify predictors of limited range of motion of the proximal interphalangeal joint (below 30°), implant-related problems and revision surgeries. The covariates included in the models were preoperative sociodemographic data, clinical measures, patient-reported outcomes and surgical details.
RESULTS
Four-hundred and thirty-one patients with 476 implants were analysed. The risk of reduction of range of movements increased with younger age and prior hand surgeries, but decreased for fingers with lax radial collateral ligament, as well as for the ring finger ( R 2 = 0.10). The little finger had a higher risk of implant-related problems. Greater surgical experience was associated with an 83% reduced risk of implant-related problems and a 76% reduced risk of revision surgery.
CONCLUSION
Greater surgical experience was associated with fewer implant-related issues or the need for revision surgery in patients after proximal interphalangeal joint surface replacement. However, the models explained only a small proportion of the variance in adverse events, suggesting that there could be additional contributing factors.
LEVEL OF EVIDENCE
IV.