Because of the unconstrained design of the implant, some soft-tissue healing must occur to provide initial stability. In the patient who has osteoarthritis, when soft-tissue stability is good, short-arc MP joint motion may be allowed as early as 4 to 7 days postoperative under careful supervision of a therapist. Motion is protected initially with dynamic and static splints (Fig. 12A,B). MP joint motion is gradually increased on a weekly basis. Light activities are allowed while the splints are being worn. In patients undergoing a single MP joint replacement, protective buddy tapping may be initiated at 1 month. Patients are weaned from the splints at 6 weeks. In the rheumatoid patient, the MP joint is immobilized in full extension for 3 to 4 weeks, with some interphalangeal motion allowed after 7 to 10 days. Early motion, as would be
allowed with silicone arthroplasty, should not be allowed with pyrolytic carbon implants because significant flexion may lead to instability.
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