Long-term Survival of Proximal Interphalangeal Joint Denervation of the Hand: Time-to-Event Analysis.

Abstract

The primary aim of this study was to assess the long-term survival rate of proximal interphalangeal (PIP) joint denervation, defined as the duration until revision with a salvage procedure. The secondary aims were to evaluate pain relief, patient satisfaction, progression of osteoarthritis, and factors associated with treatment failure. A multicenter retrospective cohort study was conducted, including patients aged ≥18 years with PIP joint arthropathy undergoing denervation surgery. Revision surgery was the endpoint for survival analysis. Pain levels, patient satisfaction, and radiographic osteoarthritis grading were recorded. A total of 116 fingers from 69 patients across two centers were included in this study. At 10 years, the revision-free survival rate was 82% (95% CI, 75-89), with all 20 (17%) revisions occurring within the first 3 years. Survival rates remained stable after the third year, with 94% (95% CI, 90-98) at 1 year, 88% (95% CI, 82-94) at 2 years, and 82% (95% CI, 75-89) at 3 years. Median pain scores significantly decreased from 8 (IQR 7-9) to 1.0 (IQR 0-2.5), representing an 87.5% relative reduction in pain intensity. Clinically, 92% of patients achieved the minimal clinically important difference for the visual analog scale, and 91% reached the substantial clinical benefit threshold. The overall patient satisfaction rate was 88%. No predictors of failure were identified in either univariate or multivariate analysis. PIP joint denervation provides durable, effective pain relief with high patient satisfaction, despite osteoarthritis progression, supporting its consideration as a surgical option for symptomatic PIP joint osteoarthritis. Therapeutic IV.