Proximal Interphalangeal Joint Surface Replacement Arthroplasty Using the WALANT Technique by Palmar Approach: A Case Report.

Abstract

Osteoarthritis of the proximal interphalangeal joint (PIPJ) is a common condition characterized by pain, weakness, stiffness, malalignment, and loss of movement in the affected hand. Conservative treatments such as medication, physical therapy, and splinting, as well as surgical procedures like synovectomy and debridement, may occasionally help; however, arthrodesis and PIPJ arthroplasty are the definitive surgical options. The goal of replacement arthroplasty is to relieve pain, restore movement, and maintain the stability of the affected joint. Designing an effective replacement arthroplasty requires a deep understanding of current biomaterials and an appreciation for the complex biomechanics of the PIP joint. The use of local anesthetic (wide-awake local anesthesia no tourniquet [WALANT]) offers advantages such as the absence of discomfort from a tourniquet, reduced personnel and sedation costs, faster recovery, and intraoperative assessment of motor function. Our objective is to report a case in which a PIPJ arthroplasty was successfully performed using the WALANT technique.