Prediction of adverse events in proximal interphalangeal joint surface-replacement implants

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