Distal Interphalangeal Joint Arthroplasty: A Narrative Review

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Joint Reconstruction

Background:

• Symptomatic distal interphalangeal (DIP) joint arthritis is often treated with arthrodesis (fusion).
• DIP joint arthroplasty has been an alternative treatment since 1977.
• This review examines evidence for DIP arthroplasty in arthritis unresponsive to conservative care.

Purpose of the Study:

• To systematically review the current evidence on distal interphalangeal (DIP) joint arthroplasty.
• To evaluate its efficacy and complication rates for treating refractory arthritis.
• To compare its outcomes with DIP arthrodesis.

Main Methods:

• Systematic literature search of PubMed, MEDLINE, and Embase databases.
• Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Risk of bias assessment using the ROBINS-I tool.

Main Results:

• Six studies (Level IV evidence) were included in the narrative review.
• DIP arthroplasty demonstrated effectiveness in pain relief and functional improvement.
• Complication rate was 15%, with instability (2.5%) and infection (2.1%) most common; re-operation rate was 8%.

Conclusions:

• DIP arthroplasty is effective for painful DIP arthritis, offering motion preservation over arthrodesis.
• A 15% complication rate necessitates careful patient selection.
• Limited high-quality evidence suggests its use should be reserved for patients prioritizing DIP motion preservation.