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

IF 2.4 2区医学 Q2 ORTHOPEDICS

Journal of Hand Surgery-American Volume Pub Date : 2026-10-01 Epub Date: 2026-08-12 DOI:10.1016/j.jhsa.2026.06.006

Esmee Kwee MD, Niek J. Nieuwdorp MSc, Camille Blaaker MSc, Liron S. Duraku MD, PhD, J. Michiel Zuidam MD, PhD

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引用次数: 0

Abstract

Purpose

Proximal interphalangeal (PIP) joint osteoarthritis frequently causes pain and functional limitation. Arthroplasty and arthrodesis can provide pain relief but are invasive, require prolonged rehabilitation, and carry substantial complication risks. PIP joint denervation has emerged as a less invasive, motion-preserving alternative. However, evidence remains limited, and its durability is unclear.

Methods

In this multicenter prospective study, 87 patients (105 joints) with symptomatic osteoarthritis underwent PIP denervation between 2016 and 2024 and had at least 12 months of follow-up. The primary outcome was procedural success, which was defined as the absence of subsequent arthroplasty or arthrodesis for persistent or recurrent symptoms. Secondary outcomes, assessed in the subgroup without repeat surgery (76 joints), included pain and function measured on 0–100 visual analog scales (VAS), as well as patient satisfaction and willingness to undergo the procedure again.

Results

At a median follow-up of 43 months (range, 12–107 months), 81% of PIP joints had not undergone conversion to arthroplasty or arthrodesis after denervation surgery. Most repeat surgeries occurred within the first postoperative year. VAS pain at rest improved from 44 ± 25 before surgery to 18 ± 26 (26-point reduction), and pain during activity improved from 63 ± 22 to 29 ± 31 (34-point reduction). VAS function increased from 47 ± 19 to 60 ± 24 (13-point improvement). Overall, 62% of patients rated their satisfaction as excellent or good, and 79% reported that they would choose the procedure again.

Conclusions

PIP denervation was associated with encouraging midterm outcomes in selected patients with symptomatic PIP joint osteoarthritis, with 81% of joints not requiring conversion to arthroplasty or arthrodesis over a 4-year follow-up.

Type of study/level of evidence

Therapeutic III.

查看原文本刊更多论文

PIP去神经治疗骨关节炎是一个持久的解决方案吗？来自多中心结果研究的结果。

目的：近端指间关节骨性关节炎（PIP）常引起疼痛和功能限制。关节置换术和关节融合术可以缓解疼痛，但具有侵入性，需要长时间的康复，并有很大的并发症风险。PIP关节去神经支配已成为一种侵入性较小、保持运动的替代方法。然而，证据仍然有限，其持久性尚不清楚。方法：在这项多中心前瞻性研究中，在2016年至2024年期间，87例（105个关节）有症状的骨关节炎患者接受了PIP去神经治疗，随访至少12个月。主要结局是手术成功，定义为没有后续的关节置换术或持续或复发症状的关节融合术。在没有重复手术的亚组（76个关节）中评估次要结果，包括以0-100视觉模拟量表（VAS）测量的疼痛和功能，以及患者满意度和再次接受手术的意愿。结果：中位随访43个月（范围12-107个月），81%的PIP关节在去神经手术后未进行关节置换或关节融合术。大多数重复手术发生在术后第一年。VAS休息时疼痛从术前的44±25分改善到18±26分（减少26分），活动时疼痛从63±22分改善到29±31分（减少34分）。VAS功能由47±19分提高至60±24分（改善13分）。总体而言，62%的患者认为他们的满意度为优秀或良好，79%的患者表示他们会再次选择这种手术。结论：在有症状的PIP关节骨性关节炎患者中，PIP去神经支配与令人鼓舞的中期结果相关，在4年的随访中，81%的关节不需要转换为关节置换术或关节融合术。研究类型/证据水平：治疗性III。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hand Surgery-American Volume 医学-外科

CiteScore

3.20

自引率

10.50%

发文量

402

审稿时长

12 weeks

期刊介绍： The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.