Complications after surface replacing and silicone PIP arthroplasty: an analysis of 703 implants

Arch Orthop Trauma Surg. 2021 Jan;141(1):173-181. doi: 10.1007/s00402-020-03663-5. Epub 2020 Nov 7.


Introduction: The aim was to analyse complications after surface replacing and silicone proximal interphalangeal (PIP) joint arthroplasty.

Materials and methods: All complications, reoperations (subsequent intervention without implant modification) and revisions (subsequent surgery with implant modification or removal) were extracted out of our registry for two cohorts: (1) Patients who received a surface replacing arthroplasty at the PIP joint using the CapFlex-PIP prosthesis and (2) patients who received a PIP silicone implant. Furthermore, radiographs were evaluated for deviations from the longitudinal finger axis.

Results: In our registry, 279 surface replacing implants and 424 silicone implants have been documented. The overall complication rate was 20% for surface replacements and 11% for silicone arthroplasties (p ≤ 0.01) with soft tissue-related events being the most prevalent in both groups. Reoperations were significantly more frequent after surface replacement (5.4%) than silicone arthroplasty (0.5%; p ≤ 0.001), while the revision rates did not differ significantly (4.4% and 3.3%, respectively; p = 0.542). Postoperative axis deviations were significantly less frequent in the surface replacement group (19% versus 58% for silicone arthroplasty; p ≤ 0.001).

Conclusion: We recommend using a surface replacing implant in fingers with preoperative axis deviations and correctable anatomical situation, bearing in mind the higher risk of a second surgery. However, treatment outcomes also need to be considered before choosing one implant over another.

Keywords: Adverse event; CapFlex arthroplasty; Finger middle joint; Implant failure; Swanson silicone implant.

MeSH terms

  • Arthroplasty, Replacement, Finger* / adverse effects
  • Arthroplasty, Replacement, Finger* / instrumentation
  • Arthroplasty, Replacement, Finger* / methods
  • Finger Joint / surgery*
  • Humans
  • Joint Prosthesis / adverse effects*
  • Postoperative Complications*
  • Reoperation
  • Silicones / adverse effects*
  • Treatment Outcome


  • Silicones