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

PURPOSE: 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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.