The proximal interphalangeal joint: arthritis and deformity

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rheumatology

Background:

• Osteoarthritis commonly affects finger joints, particularly the proximal interphalangeal (PIP) joint.
• Painful PIP joint destruction significantly impacts hand function.
• Surgical intervention is often necessary for severe PIP joint osteoarthritis.

Purpose of the Study:

• To review the indications, techniques, and outcomes of proximal interphalangeal (PIP) joint arthroplasty.
• To compare arthroplasty with arthrodesis (fusion) for PIP joint deformities.
• To discuss implant choices and post-operative rehabilitation strategies.

Main Methods:

• Review of current literature on PIP joint arthroplasty and arthrodesis.
• Discussion of surgical approaches and implant materials.
• Emphasis on the importance of pre-operative assessment and post-operative care.

Main Results:

• Joint arthroplasty provides the best functional outcome for painful, destroyed PIP joints when adequate bone stock and functional tendons are present.
• PIP joint arthrodesis is preferred for fixed swan-neck and boutonnière deformities.
• Silicone implants remain the gold standard, though newer designs offer potential advantages.
• Early protected motion is crucial for successful post-operative rehabilitation.

Conclusions:

• PIP joint arthroplasty is a viable option for managing severe PIP joint osteoarthritis, offering good functional recovery.
• Careful patient selection, appropriate surgical technique, and diligent rehabilitation are essential for optimal results.
• Revision arthroplasty can manage chronic pain but does not correct existing deformities.