Artrite da Articulação Interfalangeana Proximal

Patients › Hand

Osteoarthritis and inflammatory arthritis of the PIP joint — non-operative and surgical options.

Updated May 2026
Uma ilustração desenhada à mão de uma articulação do dedo médio desgastada e artrítica.
Uma mão afetada por artrite — inchaço e deformidade visíveis nas articulações dos dedos. PhilipPirrip / Wikimedia Commons, CC BY 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

O que você está sentindo

Você provavelmente sente dor na articulação média do seu dedo, conhecida como articulação interfalângica proximal. Essa dor frequentemente decorre de artrose por desgaste ou de danos causados por uma lesão prévia. Seu cirurgião pode sugerir essa cirurgia apenas se a dor se tornar tão intensa que impeça você de realizar tarefas diárias. Você pode notar que a dor piora após o uso da mão ou ao acordar pela manhã.

Ações simples podem se tornar muito difíceis. Você pode ter dificuldade em alcançar as costas para fechar um sutiã ou guardar a camisa. A articulação pode parecer rígida, dificultando a flexão ou extensão completa do seu dedo. Em alguns casos, a articulação pode não se mover tão bem quanto antes, e essa amplitude de movimento pode piorar ao longo do tempo. Se você tem artrite reumatoide, o tratamento precoce com medicamentos específicos pode ajudar a melhorar como você se sente.

Embora o processo da doença seja complexo, você pode esperar alívio da dor e melhor função após a cirurgia. Muitos pacientes descobrem que a substituição da superfície da articulação proporciona excelente alívio com poucos problemas. No entanto, você deve saber que o movimento do seu dedo pode diminuir ligeiramente com o passar do tempo. Se você tiver uma contratura na qual o dedo fica preso em flexão, o gesso seriado pode ajudar a corrigir isso antes ou depois da cirurgia. Seu cirurgião avaliará se este procedimento é adequado para você com base nos seus sintomas específicos e na condição da articulação.

O que está realmente acontecendo

No seu dedo, o revestimento liso nas extremidades dos ossos, chamado cartilagem, desgasta-se ao longo do tempo. Esta osteoartrite por desgaste atua como um amortecedor que perdeu sua proteção. À medida que a cartilagem se torna mais fina, os ossos esfregam uns contra os outros, causando dor e rigidez. Você pode notar que tem uma amplitude de movimento menor ao realizar tarefas diárias, porque a articulação já não desliza suavemente.

O problema vai além dos ossos. Os tendões, que são como cordas de fibras conectando o músculo ao osso, alteram-se precocemente na doença. Esses tendões atravessam múltiplas articulações, portanto, uma alteração em uma área afeta o movimento de todo o seu dedo. Essa interdependência significa que, quando uma parte do seu dedo muda, as outras têm dificuldade para acompanhar. Com o tempo, essas alterações nos tendões e estruturas relacionadas levam às deformidades que você observa.

Seu cirurgião observa que esse processo é impulsionado pela forma como as forças se propagam pela sua mão. Mulheres com essa condição frequentemente apresentam forças manuais significativamente menores, com uma redução média de 30% na maioria dos tipos de força. As forças de cisalhamento compressivo também podem danificar a articulação ao longo do tempo, levando a um desgaste adicional. Quando a cápsula articular, a bainha ao redor da articulação, e os ligamentos perdem sua estabilidade, os ossos se deslocam. Esse deslocamento cria a dor e a função limitada que o levam a consultar seu cirurgião.

O que podemos fazer a respeito

A sua jornada frequentemente começa com o autocuidado e a fisioterapia. Se você tem um dedo rígido, o molde seriado é um método eficaz para corrigir contraturas de flexão em pacientes selecionados com artrite. Este processo ajuda você a recuperar o movimento sem cirurgia. Seu cirurgião também pode recomendar exercícios para manter a articulação flexível. Você deve dar uma chance justa a essas opções não cirúrgicas antes de considerar etapas mais invasivas.

Se o cuidado simples não for suficiente, seu cirurgião pode discutir o manejo médico. Embora as evidências não detalhem nomes específicos de medicamentos ou tipos de injeções para esta articulação, elas confirmam que o alívio da dor é um objetivo primário. Para alguns, o foco permanece no manejo dos sintomas para manter a função. Se a artrize causar dor funcional invalidante, seu cirurgião pode considerar opções cirúrgicas específicas, como a prótese TACTYS, excepcionalmente. No entanto, para muitos, o foco está em manter a articulação funcionando bem enquanto se gerencia o desconforto.

Quando o tratamento conservativo atinge seu limite, a cirurgia torna-se uma opção confiável. A artroplastia com implante da articulação interfalangiana proximal é uma escolha boa e confiável para a artrite sintomática, dado o contexto clínico adequado. Este procedimento pode proporcionar alívio confiável e duradouro da dor e manutenção da função. A maioria dos pacientes retorna ao trabalho após uma mediana de 8 semanas após esta cirurgia. Embora a articulação possa parecer melhor, você deve ser avisado de que a amplitude de movimento pode deteriorar-se ao longo do tempo com certos implantes. Seu cirurgião ajudará você a decidir se este é o passo certo para o seu dedo específico.

Quando procurar um especialista

Procure uma avaliação especializada se tiver dor persistente devido à artrose por desgaste ou artrose pós-traumática que não melhora com repouso. Procure ajuda se apresentar fraqueza, instabilidade ou bloqueio no dedo. Entre em contato com seu médico se os sintomas interferirem no seu sono ou no trabalho. Você também deve buscar orientação se notar uma piora súbita do seu quadro. Esteja ciente de que a amplitude de movimento pode deteriorar-se ao longo do tempo. Se você tem diabetes, discuta o maior risco de complicações com seu cirurgião antes de considerar a cirurgia.


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

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