Denervation with Cheilectomy of the Distal Interphalangeal Joint: Technique and Medium-Term Results.

PURPOSE: Osteoarthritis of the distal interphalangeal (DIP) joint is highly prevalent and often managed with arthrodesis, which sacrifices motion and carries a risk of complications. Joint denervation preserves motion but has traditionally failed to address the aesthetic concerns associated with Heberden nodes. This study aims to describe the DIP joint denervation associated with cheilectomy and to report its medium-term outcomes regarding pain, motion, aesthetics, and complications.

METHODS

A retrospective cohort study was conducted on patients who underwent denervation of the DIP joint with cheilectomy for osteoarthritis between January 2016 and December 2024. Outcomes included pain assessment using the visual analog scale, active range of motion, radiographic osteoarthritis progression (Kellgren-Lawrence grading), sensory evaluation (Weber two-point discrimination), patient satisfaction, and complications.

RESULTS

The study included 27 DIP joints in 11 patients (all females; mean age, 65.5 years). At a mean follow-up of 4.2 years (range 1.2-7.7 years), a significant reduction in pain was observed, with the mean visual analog scale score decreasing from nine before surgery to two after surgery (P < .001). Range of motion significantly improved from a mean of 36° to 39° (P < .05). No significant changes in sensibility were detected. Radiographic progression occurred in three joints. All patients were satisfied with the aesthetic outcome and would choose the procedure again. No major complications were reported; two cases of transient paresthesia resolved spontaneously.

CONCLUSIONS

Denervation with cheilectomy of the DIP joint is an effective and safe procedure that provides significant and lasting pain relief, preserves joint motion, and improves the aesthetic appearance of the digit by addressing bony deformities. It presents a compelling motion-preserving alternative to arthrodesis for symptomatic DIP joint osteoarthritis.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.