Is PIP Denervation for Osteoarthritis a Durable Solution? Results from a Multicenter Outcome Study

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Osteoarthritis Treatment

Background:

• Proximal interphalangeal (PIP) joint osteoarthritis causes significant pain and functional limitations.
• Traditional treatments like arthroplasty and arthrodesis are invasive with risks.
• PIP joint denervation presents a less invasive, motion-preserving alternative, but evidence on its durability is limited.

Purpose of the Study:

• To evaluate the midterm outcomes of PIP joint denervation for symptomatic osteoarthritis.
• To assess procedural success, pain reduction, functional improvement, and patient satisfaction.

Main Methods:

• A multicenter prospective study included 87 patients (105 PIP joints) with symptomatic osteoarthritis undergoing denervation.
• The primary outcome was success, defined as no subsequent arthroplasty or arthrodesis.
• Secondary outcomes included pain and function via Visual Analog Scales (VAS), patient satisfaction, and willingness to repeat the procedure.

Main Results:

• At a median follow-up of 43 months, 81% of joints did not require conversion to arthroplasty or arthrodesis.
• Significant improvements were observed in VAS pain at rest (26-point reduction) and during activity (34-point reduction).
• VAS function improved by 13 points, with 62% of patients reporting good to excellent satisfaction and 79% willing to undergo the procedure again.

Conclusions:

• PIP joint denervation shows promising midterm outcomes for selected patients with symptomatic PIP joint osteoarthritis.
• The procedure is associated with a high rate of avoiding further invasive surgery and provides significant pain relief and functional gains.
• Patient satisfaction and willingness to repeat the procedure further support its efficacy as a motion-preserving treatment option.