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

Abstract

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. 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. 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. 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. Therapeutic III.