PIP Joint Arthritis Info Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
What you're feeling
You may feel pain in the middle joint of your finger. This is often caused by wear-and-tear arthritis or damage from a past injury. The pain can be deep and aching. It may also feel sharp when you move the finger.
The pain often gets worse after you use your hand. Tasks like lifting groceries, opening jars, or typing can make it throb. You might notice stiffness when you first wake up in the morning. This stiffness usually eases after you move your hand for a few minutes. However, the joint may feel stiff again after a long day of activity.
Daily tasks can become difficult. You might struggle to tuck in a shirt or reach behind your back to fasten a bra. Simple grips, like holding a cup or turning a doorknob, may cause discomfort. Some patients find that sleeping on their side puts pressure on the joint, making it harder to rest.
In some cases, the joint may not straighten fully. This is called a flexion contracture. You might notice your finger stays slightly bent. Serial casting can help correct this in selected patients.
If your pain is severe and stops you from doing normal activities, surgery might be an option. PIP joint replacement is a reliable choice for degenerative, post-traumatic, or inflammatory arthritis. It aims to relieve pain and restore function.
You should know that range of motion may change over time. Studies show that movement can deteriorate with longer follow-up. Despite this, many patients report good pain relief and satisfaction. Most people return to work after a median of 8 weeks.
Your surgeon will assess if you are a good candidate. Treatment of the long finger may be a relative contraindication. Early diagnosis of conditions like rheumatoid arthritis is important. Referral to a specialist can improve outcomes.
What's actually happening
Your hand joints are designed to move smoothly. A thin layer of cartilage acts like a shock absorber between the bones. In osteoarthritis, this coating wears down. The bones begin to rub against each other. This causes pain and stiffness.
The muscles and tendons in your hand work as a team. They bridge multiple joints to create movement. When arthritis develops, this teamwork breaks down. Your hand loses strength. Studies show that women with hand arthritis have 30% less grip force than healthy women. You may find it harder to hold objects or perform daily tasks.
As the disease progresses, your fingers may not move through their full range. You might notice a smaller arc of motion when you try to make a fist or grasp items. The tendons and surrounding structures change shape. These changes are often the main cause of finger deformities, especially in the early stages.
At the base of your thumb, the joint faces unique stresses. Compressive shear forces act on it over time. This can lead to wear-and-tear arthritis in the trapeziometacarpal joint. The ligaments that stabilize this joint become less effective. This instability contributes to the pain and loss of function you feel at the thumb base.
Understanding these mechanical changes helps explain your symptoms. The pain comes from bone-on-bone friction and inflammation. The stiffness comes from structural changes in the tendons and joints. Your surgeon uses this knowledge to plan treatment. The goal is to restore smooth movement and relieve pain.
What we can do about it
At Mater Private Hospital Rockhampton, Dr Kieran Hirpara approaches this condition by matching the treatment to your daily needs. We start with the least invasive options. You can try changing how you use your hand to avoid painful movements. Gentle exercises help keep the joint mobile and strengthen the surrounding muscles. We often recommend splints to support the joint during activities. Give these measures at least six weeks to show if they help.
If pain persists, we discuss medical options. Over-the-counter pain relievers can reduce discomfort. Anti-inflammatory medications help calm swelling in the joint. We may offer an injection to provide longer relief. Cortisone injections reduce inflammation and can last for several months. Hyaluronic acid injections aim to lubricate the joint, though effects vary. Platelet-rich plasma injections use your own blood components to support healing, but evidence for finger joints is still growing. These treatments manage symptoms but do not reverse the arthritis.
When conservative care no longer gives enough improvement, we consider surgery. This is a shared decision based on your pain levels and function. We look at whether the arthritis is affecting your ability to work or enjoy daily tasks. If you are a candidate, we may discuss joint replacement or fusion. These procedures aim to relieve pain and restore stability. We review the risks and benefits with you before proceeding.
What to expect
Your outlook after joint replacement in your finger depends on your specific condition and how your body heals. For many patients with wear-and-tear arthritis, the procedure provides reliable, long-term pain relief. You can expect the joint to remain stable and functional for years. Studies show that good pain relief and overall satisfaction are maintained for at least two years after surgery. Some patients report being essentially pain-free and well-functioning even decades later.
Recovery is a gradual process. Most patients return to work after a median of 8 weeks. During this time, you will need to follow your surgeon’s advice closely to minimize complications. Reducing postoperative issues is key to a smooth recovery and lower healthcare costs. While you may experience good range of motion initially, be aware that the joint’s movement can deteriorate over time. This is a known trend with some implant types, particularly those used in the proximal interphalangeal joint.
If left untreated, arthritis in this joint often leads to persistent pain and stiffness. Management options vary. In some cases, non-surgical methods like serial casting can help correct stiffness in selected patients. For others, joint replacement remains a good and reliable option for symptomatic arthritis. It is important to note that treating the long finger may be a relative contraindication to this surgery, meaning it might not be the best choice for everyone. Factors such as diabetes or surgeon experience can also influence your risk of complications.
Your surgeon will discuss whether you are a suitable candidate based on your unique clinical setting. The goal is to provide pain relief and maintain function. While outcomes are generally positive, individual results vary. You should have realistic expectations about the longevity of the implant and the potential for future changes in joint movement. Regular follow-up ensures your surgeon can monitor your progress and address any concerns early.
When to see someone
Ask for a specialist review if you have persistent pain in your middle finger joint that does not improve with rest. Seek care if you notice weakness, instability, or if the joint locks or gives way. Contact your doctor if symptoms interfere with your sleep or work, or if you experience a sudden worsening. PIP joint arthroplasty is indicated for osteoarthritis or posttraumatic arthritis. It is a reliable option for symptomatic degenerative, post-traumatic, or inflammatory arthritis in the proper clinical setting. We propose this treatment exceptionally if the arthritis causes invalidating functional pain. Early diagnosis and proper management can help preserve your hand function.
Evidence & references
Overview
- Surface replacement arthroplasty of the proximal interphalangeal joint using a volar approach can result in excellent range of motion, function, and pain relief with minimal complications in active patients with osteoarthritis or posttraumatic arthritis [1].
- Treatment of the long finger may be a relative contraindication to proximal interphalangeal joint arthroplasty [2].
- There has been an increased use of primary proximal interphalangeal joint arthroplasty utilization for patients with osteoarthritis, whereas revision proximal interphalangeal joint arthroplasty has decreased [3].
- Treatment of metacarpophalangeal and proximal interphalangeal joint osteoarthritis with an anatomically neutral implant can provide reliable, long-term pain relief and maintenance of function [4].
- Patients returned to work after a median of 8 weeks following proximal interphalangeal joint arthroplasty [5].
- Serial casting is an effective method to correct flexion contractures in proximal interphalangeal joints in selected patients with arthritis [6].
- Minimizing postoperative complications after metacarpophalangeal and proximal interphalangeal joint arthroplasty is one avenue to decrease health care costs [7].
- Proximal interphalangeal joint implant arthroplasty is a good and reliable option for symptomatic proximal interphalangeal joint degenerative, post-traumatic, or inflammatory arthritis given the proper clinical setting [10].
- Minimum two years of follow-up evaluation of the self-locking finger joint implant proximal interphalangeal joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion [11].
- Silicone arthroplasty for osteoarthritis of the proximal interphalangeal joint remains a good option for pain relief [13].
- Pyrolytic carbon hemiarthroplasty appears to be a viable alternative to total joint arthroplasty in the treatment of proximal interphalangeal joint arthritis [16].
Anatomy & Pathophysiology
- Women with hand osteoarthritis exhibited significantly lower intrinsic hand forces compared to healthy women, with a mean decrease of 30% across most force types [21].
- People with hand arthritis move through a smaller arc of motion when performing some functional tasks as compared with controls [32].
- The internal structure and material properties of the phalanges play a significant role in both the magnitude and distribution of stresses in the MCP joint during common tasks [24].
- Interdependency of joints is a primary feature of finger function [39].
- The function of a muscle with respect to a certain joint cannot be inferred from the position of the muscle with respect to that one joint alone due to tendons bridging multiple joints [39].
- Changes occurring in the tendons and related structures are the most important factor in the development of finger deformities, especially in early stages [27].
- Detailed understanding of the functional anatomy and related pathologic features of the trapeziometacarpal joint complex provides the basis for treatment of acquired afflictions at the base of the human thumb [31].
- Compressive shear forces can lead over time to trapeziometacarpal joint osteoarthritis [33].
- In most degrees of freedom of metacarpal movement relative to the trapezium, the dorsoradial ligament (DRL) is relatively more important than the deep anterior oblique ligament (dAOL) in providing stability to the TMC joint [36].
- Thumb basal joint arthritis is a progressive disease with substantial new biomechanical and longitudinal clinical studies changing prevailing opinions on serial degenerative changes [22].
- Type I and III wrists had radiographic progression and ultimately underwent deformation [20].
- Most of the outcome measures associated with hand OA or RA are related to body structures and body functions or activity limitations and participation restrictions [30].
Classification
- Surface replacement arthroplasty of the proximal interphalangeal joint using a volar approach can result in excellent range of motion, function, and pain relief with minimal complications in active patients with osteoarthritis or posttraumatic arthritis [1].
- Treatment of the long finger may be a relative contraindication to proximal interphalangeal joint arthroplasty [2].
- Primary proximal interphalangeal joint arthroplasty utilization has increased for patients with osteoarthritis, whereas revision utilization has decreased [3].
- Treatment of metacarpophalangeal and proximal interphalangeal joint osteoarthritis with an anatomically neutral implant can provide reliable, long-term pain relief and maintenance of function [4].
- Patients returned to work after a median of 8 weeks following proximal interphalangeal joint arthroplasty [5].
- Serial casting is an effective method to correct flexion contractures in proximal interphalangeal joints in selected patients with arthritis [6].
- Minimizing postoperative complications after metacarpophalangeal and proximal interphalangeal joint arthroplasty is one avenue to decrease health care costs [7].
- The TACTYS prosthesis should be proposed exceptionally if the proximal interphalangeal joint arthritis causes invalidating functional pain [8].
- Proximal interphalangeal joint implant arthroplasty is a good and reliable option for symptomatic proximal interphalangeal joint degenerative, post-traumatic, or inflammatory arthritis given the proper clinical setting [10].
- Radiological osteoarthritis after a mallet finger fracture is similar to the natural degenerative process in the distal interphalangeal joint and is accompanied by a decrease in range of motion of the distal interphalangeal joint, which does not clinically affect patient-reported outcome measures [12].
- Pyrolytic carbon hemiarthroplasty appears to be a viable alternative to total joint arthroplasty in the treatment of proximal interphalangeal joint arthritis [16].
- Cortical breaks were commonly visualized in metacarpophalangeal and proximal interphalangeal joints with high-resolution peripheral quantitative CT and microCT [17].
- Expert consensus can be reached to identify putative risk factors for interphalangeal joint osteoarthritis, though the number identified was low and often required multiple Delphi rounds [18].
- The revision rate for the LPM prosthesis was higher than in published series for other proximal interphalangeal joint implants, warranting close surveillance of all patients with this prosthesis currently in situ [43].
- Surface replacement arthroplasty using the SR PIP implant continues to be an option for patients with osteoarthritis of the proximal interphalangeal joint [45].
Clinical Presentation
- PIP joint arthroplasty may be a relative contraindication for treatment of the long finger [2].
- Patients with PIP joint arthritis causing invalidating functional pain should be considered for arthroplasty [8].
- PIPJ implant arthroplasty is a good and reliable option for symptomatic PIPJ degenerative, post-traumatic, or inflammatory arthritis given the proper clinical setting [10].
- Treatment of MCP and PIP osteoarthritis with an anatomically neutral implant can provide reliable, long-term pain relief and maintenance of function [4].
- Silicone arthroplasty for osteoarthritis of the PIP remains a good option for pain relief [13].
- Surface replacement arthroplasty of the PIP joint using a volar approach can result in excellent range of motion, function, and pain relief with minimal complications in active patients with osteoarthritis or posttraumatic arthritis [1].
- Surface replacement arthroplasty of the PIP joint using a volar approach has the tendency to deteriorate in range of motion with longer follow-up [15].
- Pyrolytic carbon hemiarthroplasty for PIP joint arthritis results in good pain relief and stable radiographic integration at 5 years, with no late revisions or loosening observed, despite no improvement in range of motion [19].
- Patients should be advised that PIPJ range of motion deteriorates over time following pyrolytic carbon hemiarthroplasty [9].
- Minimum two-year follow-up evaluation of the Self Locking Finger Joint (SLFJ) implant PIP joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion [11].
- Autologous rib perichondrium transplants restored injured PIP and MCP joints that remained essentially pain-free and mostly well-functioning without need for additional surgeries up to 41 years after the procedure [14].
- Serial casting is an effective method to correct flexion contractures in PIP joints in selected patients with arthritis [6].
- Cortical breaks were commonly visualized in MCP and PIP joints with high-resolution peripheral quantitative CT and microCT [17].
- Expert consensus can be reached to identify putative risk factors for IP joint osteoarthritis, though the number identified was low and often required multiple Delphi rounds [18].
- Treatment modalities for PIP joint arthritis are currently limited, and the disease process involves a complex interplay of biochemical, metabolic, and genetic factors rather than simple mechanical stress [40].
- Early diagnosis of rheumatoid arthritis is important, and referral to a rheumatologist followed by treatment with disease-modifying antirheumatic agents has been shown to improve outcomes [35].
Investigations
- The volar approach to proximal interphalangeal joint surface replacement arthroplasty can result in excellent range of motion, function, and pain relief with minimal complications in active patients with osteoarthritis or posttraumatic arthritis [1].
- Treatment of the long finger may be a relative contraindication to proximal interphalangeal joint arthroplasty [2].
- There has been an increased use of primary proximal interphalangeal joint implant arthroplasty utilization for patients with osteoarthritis, whereas revision utilization has decreased [3].
- Treatment of metacarpophalangeal and proximal interphalangeal joint osteoarthritis with an anatomically neutral implant can provide reliable, long-term pain relief and maintenance of function [4].
- Patients returned to work after a median of 8 weeks following proximal interphalangeal joint arthroplasty [5].
- Serial casting is an effective method to correct flexion contractures in proximal interphalangeal joints in selected patients with arthritis [6].
- Proximal interphalangeal joint implant arthroplasty should be proposed exceptionally if the joint arthritis causes invalidating functional pain [8].
- Patients should be advised that proximal interphalangeal joint range of motion deteriorates over time following pyrolytic carbon hemiarthroplasty [9].
- Proximal interphalangeal joint implant arthroplasty is a good and reliable option for symptomatic proximal interphalangeal joint degenerative, post-traumatic, or inflammatory arthritis given the proper clinical setting [10].
- Radiological osteoarthritis after a mallet finger fracture is similar to the natural degenerative process in the distal interphalangeal joint and is accompanied by a decrease in range of motion of the distal interphalangeal joint, which does not clinically affect patient-reported outcome measures [12].
- Silicone arthroplasty for osteoarthritis of the proximal interphalangeal joint remains a good option for pain relief [13].
- Perichondrium transplants restored injured proximal interphalangeal and metacarpophalangeal joints that remained essentially pain-free and mostly well-functioning without need for additional surgeries up to 41 years after the procedure [14].
- Proximal interphalangeal joint range of motion after surface replacement arthroplasty through a volar approach has the tendency to deteriorate with a longer follow-up [15].
- Cortical breaks were commonly visualized in metacarpophalangeal and proximal interphalangeal joints with high-resolution peripheral quantitative CT and microCT [17].
- Expert consensus can be reached to identify putative risk factors for interphalangeal joint osteoarthritis, though the number identified was low and often required multiple Delphi rounds [18].
- Pyrolytic carbon prosthesis replacement of the proximal interphalangeal joint reports good pain relief and stable radiographic integration at 5 years, with no late revisions or loosening observed, despite no improvement in range of motion [19].
- Type I and III wrists had radiographic progression and ultimately underwent deformation [20].
- All described techniques for proximal interphalangeal joint arthrodesis can achieve the goal of fusing an osteoarthritic joint [47].
- In patients with established hand osteoarthritis, clinical involvement of the thumb base joint is associated with a higher clinical burden, whereas radiological involvement of the thumb base joint is associated with older age and more structural abnormalities [49].
Treatment
- Surface replacement arthroplasty of the proximal interphalangeal joint using a volar approach can result in excellent range of motion, function, and pain relief with minimal complications in active patients with osteoarthritis or posttraumatic arthritis [1].
- Treatment of the long finger may be a relative contraindication to proximal interphalangeal joint arthroplasty [2].
- There has been an increased use of primary proximal interphalangeal joint arthroplasty utilization for patients with osteoarthritis, whereas revision proximal interphalangeal joint arthroplasty has decreased [3].
- Treatment of metacarpophalangeal and proximal interphalangeal joint osteoarthritis with an anatomically neutral implant can provide reliable, long-term pain relief and maintenance of function [4].
- Patients returned to work after a median of 8 weeks following proximal interphalangeal joint arthroplasty [5].
- Serial casting is an effective method to correct flexion contractures in proximal interphalangeal joints in selected patients with arthritis [6].
- Minimizing postoperative complications after metacarpophalangeal and proximal interphalangeal joint arthroplasty is one avenue to decrease health care costs [7].
- The TACTYS prosthesis should be proposed exceptionally if the proximal interphalangeal joint arthritis causes invalidating functional pain [8].
- Patients should be advised that proximal interphalangeal joint range of motion deteriorates over time following pyrolytic carbon hemiarthroplasty [9].
- Proximal interphalangeal joint implant arthroplasty is a good and reliable option for symptomatic proximal interphalangeal joint degenerative, post-traumatic, or inflammatory arthritis given the proper clinical setting [10].
- Minimum two years of follow-up evaluation of the Self Locking Finger Joint implant proximal interphalangeal joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion [11].
- Silicone arthroplasty for osteoarthritis of the proximal interphalangeal joint remains a good option for pain relief [13].
- Proximal interphalangeal joint range of motion after surface replacement arthroplasty through a volar approach has the tendency to deteriorate with a longer follow-up [15].
- Pyrolytic carbon hemiarthroplasty appears to be a viable alternative to total joint arthroplasty in the treatment of proximal interphalangeal joint arthritis [16].
- The combination of distal interphalangeal joint arthrodesis and proximal interphalangeal joint Swanson arthroplasty resulted in a favourable outcome in terms of simultaneous bony union and flexibility [41].
Complications
- Treatment of the long finger may be a relative contraindication to PIPJ arthroplasty [2].
- Minimizing postoperative complications after MCP and PIP joint arthroplasty is one avenue to decrease health care costs [7].
- Patients should be advised that PIPJ range of motion deteriorates over time [9].
- Diabetes and surgeon experience were identified as factors increasing the risk of postoperative complications in DIP and thumb IP joint arthrodeses [44].
Recovery
- Patients returned to work after a median of 8 weeks following PIP arthroplasty [5].
- Minimizing postoperative complications after MCP and PIP joint arthroplasty is one avenue to decrease health care costs [7].
- Patients should be advised that PIPJ ROM deteriorates over time [9].
- The minimum 2 years of follow-up evaluation of the SLFJ implant PIP joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion [11].
- Perichondrium transplants restored injured PIP and MCP joints that remained essentially pain-free and mostly well-functioning without need for additional surgeries up to 41 years after the procedure [14].
- PIP ROM after SRA through a volar approach has the tendency to deteriorate with a longer follow-up [15].
- The study reports good pain relief and stable radiographic integration at 5 years, with no late revisions or loosening observed, despite no improvement in range of motion [19].
Key Evidence
- [L4] The volar approach to PIP SRA can result in excellent range of motion, function, and pain relief with minimal complications in active patients with osteoarthritis or posttraumatic arthritis. [1] (10.1016/j.jhsa.2011.03.003)
- [L1] Treatment of the long finger may be a relative contraindication to PIPJ arthroplasty. [2] (10.1177/1558944718791186)
- [L4] The data demonstrate an increased use of primary PIPA utilization for patients with OA, whereas revision PIPA decreased. [3] (10.1177/1558944719837009)
- [L4] Treatment of MCP and PIP osteoarthritis with an anatomically neutral implant can provide reliable, long-term pain relief and maintenance of function. [4] (10.1016/j.jhsa.2008.11.005)
- [L3] Patients returned to work after a median of 8 weeks following PIP arthroplasty. [5] (10.1177/15589447221141485)
- [L4] SC is an effective method to correct flexion contractures in PIP joints in selected patients with arthritis. [6] (10.1016/j.jht.2015.11.005)
- [L3] Minimizing postoperative complications after MCP and PIP joint arthroplasty is one avenue to decrease health care costs. [7] (10.1016/j.jhsa.2019.11.002)
- [L4] It should be proposed exceptionally if the PIP joint arthritis causes invalidating functional pain. [8] (10.1177/15589447211030962)
- [L4] Patients should be advised that PIPJ ROM deteriorates over time. [9] (10.1016/j.jhsa.2023.11.007)
- [L4] PIPJ implant arthroplasty is a good and reliable option for symptomatic PIPJ degenerative, post-traumatic or inflammatory arthritis given the proper clinical setting. [10] (10.1177/17531934241265837)
- [L4] The minimum 2 years of follow-up evaluation of the SLFJ implant PIP joint arthroplasty demonstrated good pain relief and good overall patient satisfaction while maintaining joint range of motion. [11] (10.1177/1558944717726136)
- [L4] Radiological OA after an MFF is similar to the natural degenerative process in the DIP joint and is accompanied by a decrease in range of motion of the DIP joint, which does not clinically affect PROMs. [12] (10.1016/j.jhsa.2023.03.027)
- [L4] Silicone arthroplasty for osteoarthritis of the PIP remains a good option for pain relief. [13] (10.1177/1558944718769427)
- [L4] Perichondrium transplants restored injured PIP and MCP joints that remained essentially pain-free and mostly well-functioning without need for additional surgeries up to 41 years after the procedure. [14] (10.1186/s12891-020-03310-5)
- [L4] PIP ROM after SRA through a volar approach has the tendency to deteriorate with a longer follow-up. [15] (10.1177/1558944718787332)
- [L4] Pyrocarbon hemiarthroplasty appears to be a viable alternative to total joint arthroplasty in the treatment of PIP joint arthritis. [16] (10.1016/j.jhsa.2014.12.016)
- [L4] Cortical breaks were commonly visualized in MCP and PIP joints with HR-pQCT and microCT. [17] (10.1186/s12891-016-1148-y)
- [L4] Expert consensus can be reached to identify putative risk factors for IP joint OA, though the number identified was low and often required multiple Delphi rounds. [18] (10.1177/1753193419865872)
- [L4] The study reports good pain relief and stable radiographic integration at 5 years, with no late revisions or loosening observed, despite no improvement in range of motion. [19] (10.1177/1753193413479527)
- [L2] Type I and III wrists had radiographic progression and ultimately underwent deformation. [20] (10.1016/j.jhsa.2009.01.016)
- [L3] Women with hand osteoarthritis exhibited significantly lower intrinsic hand forces compared to healthy women, with a mean decrease of 30% across most force types. [21] (10.1016/j.jht.2024.02.005)
- [L5] Thumb basal joint arthritis is a progressive disease with substantial new biomechanical and longitudinal clinical studies changing prevailing opinions on serial degenerative changes. [22] (10.5435/jaaos-d-17-00374)
- [L5] The internal structure and material properties of the phalanges were found to play a significant role in both the magnitude and distribution of stresses. [24] (10.1007/s11552-012-9430-4)
- [L4] The most important factor in the development of finger deformities is the changes occurring in the tendons and related structures, especially in early stages. [27] (10.2106/00004623-195739030-00006)
- [L2] Most of the outcome measures associated with hand OA or RA are related to body structures and body functions or activity limitations and participation restrictions. [30] (10.1016/j.jht.2019.12.015)
- [L5] Detailed understanding of the functional anatomy and related pathologic features of the trapeziometacarpal joint complex provides the basis for treatment of acquired afflictions at the base of the human thumb and a model for the more general study of idiopathic osteoarthritis. [31] (10.1097/01.blo.0000176968.28247.5c)
- [L3] This study demonstrated that people with hand arthritis move through a smaller arc of motion when performing some functional tasks as compared with the controls, and that with instruction on joint protection techniques, participants made significant changes in the amount of movement used to perform tasks, which supports a proof of principle of joint protection. [32] (10.1016/j.jht.2020.10.010)
- [L5] The resulting compressive shear forces can lead over time to trapeziometacarpal joint osteoarthritis. [33] (10.1016/j.jhsa.2010.10.029)
- [L5] Early diagnosis of rheumatoid arthritis is important, and referral to a rheumatologist followed by treatment with disease-modifying antirheumatic agents has been shown to improve outcomes. [35] (10.1016/j.jhsa.2011.01.036)
- [L5] In most degrees of freedom of metacarpal movement relative to the trapezium, the DRL is relatively more important than the dAOL in providing stability to the TMC joint. [36] (10.1016/j.jhsa.2006.12.002)
- [L5] The paper concludes that interdependency of joints is a primary feature of finger function, and that the function of a muscle with respect to a certain joint cannot be inferred from the position of the muscle with respect to that one joint alone due to tendons bridging multiple joints. [39] (10.2106/00004623-196345080-00007)
- [L5] Treatment modalities for proximal interphalangeal joint arthritis are currently limited, and the disease process involves a complex interplay of biochemical, metabolic, and genetic factors rather than simple mechanical stress. [40] (10.1016/j.jhsa.2010.09.002)
- [L4] The combination of DIP arthrodesis and PIP Swanson arthroplasty resulted in a favourable outcome in terms of simultaneous bony union and flexibility. [41] (10.1177/17531934231215790)
- [L4] The revision rate for the LPM prosthesis was higher than in published series for other PIP joint implants, with close surveillance of all patients with this prosthesis currently in situ recommended. [43] (10.1177/1753193407087864)
- [L3] Diabetes and surgeon experience were identified as factors increasing the risk of postoperative complications in these DIP/thumb IP joint arthrodeses. [44] (10.1186/s12891-024-07361-w)
- [L4] Surface replacement arthroplasty using the SR PIP implant continues to be an option for patients with osteoarthritis of the PIP joint. [45] (10.1016/j.jhsa.2014.11.015)
- [L1] All described techniques can achieve the goal of fusing an osteoarthritic joint. [47] (10.1530/eor-21-0102)
- [L3] In patients with established hand OA clinical involvement of the TBJ is associated with a higher clinical burden whereas radiological involvement of the TBJ is associated with older age and more structural abnormalities. [49] (10.1016/j.jht.2014.01.006)
References
[1] Surface Replacement Arthroplasty of the Proximal Interphalangeal Joint Using a Volar Approach: Case Series. The Journal of Hand Surgery. 2011. DOI: 10.1016/j.jhsa.2011.03.003 [2] Prosthetic Arthroplasty of Proximal Interphalangeal Joints for Treatment of Osteoarthritis and Posttraumatic Arthritis: Systematic Review and Meta-Analysis Comparing the Three Ulnar Digits With the Index Finger. HAND. 2018. DOI: 10.1177/1558944718791186 [3] Trends in Primary Proximal Interphalangeal Joint System and Revisions for Osteoarthritis of the Hand in the Medicare Database. HAND. 2019. DOI: 10.1177/1558944719837009 [4] Anatomically Neutral Silicone Small Joint Arthroplasty for Osteoarthritis. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2008.11.005 [5] Type of Work and Preoperative Ability to Perform Work Affect Return to Usual Work Following Proximal Interphalangeal Joint Arthroplasty for Osteoarthritis. HAND. 2022. DOI: 10.1177/15589447221141485 [6] Effects of serial casting in the treatment of flexion contractures of proximal interphalangeal joints in patients with rheumatoid arthritis and juvenile idiopathic arthritis: A retrospective study. Journal of Hand Therapy. 2016. DOI: 10.1016/j.jht.2015.11.005 [7] National Prevalence of Complications and Cost of Small Joint Arthroplasty for Hand Osteoarthritis and Post-Traumatic Arthritis. The Journal of Hand Surgery. 2020. DOI: 10.1016/j.jhsa.2019.11.002 [8] Arthroplasty of the Proximal Interphalangeal Joint With the TACTYS Prosthesis: Clinical and Radiographic Results With a Mean Follow-up of 5 Years. HAND. 2022. DOI: 10.1177/15589447211030962 [9] Pyrolytic Carbon Hemiarthroplasty for Proximal Interphalangeal Joint Arthritis, Long-Term Follow-Up. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2023.11.007 [10] Proximal interphalangeal joint arthroplasty: current trends and evidence-based practice. 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