If you are in pain due to arthritis of the PIP joints, there are several treatments available for you. One option is surgery. Another is a non-operative treatment. In addition, you can try to heal the pain yourself.
The PIP joint is a common site for osteoarthritis. In addition to pain and loss of function, it may also cause deformity. There are several total joint devices that can be used to reconstruct this joint. These include intra-articular implants, adduction-abduction prostheses, and fusions.
Arthrodesis of the PIP joint has been found to be successful in alleviating pain. Its effectiveness depends on the stage of the disease. However, complications limit its success.
Patients with rheumatoid arthritis often have poorer outcomes. Additionally, patients with post-traumatic arthritis have worse outcomes. Therefore, the surgical approach needs to be improved.
Pyrocarbon prostheses are another potential treatment option. They reduce pain and improve bone fixation. A recent study evaluated the effects of pyrolytic carbon PIP arthroplasty on bone fixation, motion, and pain.
The authors of this study included 20 patients with 29 implants. During the follow-up period, the mean Michigan Hand Outcomes Questionnaire (MHQ) score was improved from 45 before surgery to 71 after 5 years. The patients reported significant improvement in grip strength from 47 pounds to 63 pounds.
Pyrocarbon prostheses have a promising future in osteoarthritis patients. The authors observed that the ROM of the affected PIP joint increased from 42 degrees to 51 degrees in one year. However, they concluded that the subjective functional outcomes were disappointing in 5 patients.
Surgical techniques used to treat degenerative joint diseases such as osteoarthritis of the PIP joint include synovectomy, extensor tendon relocation, and intrinsic release. Depending on the stage of the disease, other options may be required.
Several total joint devices have been developed for reconstructing the MCP and PIP joints. Several of these prostheses have been approved for humanitarian use, but additional surveys will be needed to determine their effectiveness.
PIP joint fusion
The DIP joint is a common area for osteoarthritis. This type of arthritis often presents with pain and swelling. If the symptoms are severe, surgical intervention may be necessary. Several implant types are available to treat the condition.
Pyrocarbon prostheses have been shown to provide good pain relief and preserve motion. However, some complications arise with these implants. For instance, periprosthetic cysts are often found on clinical inspection of the DIP joint. Other complications include silicone synovitis and fracture of the implant.
There are several alternatives to surgery including arthrodesis, intrinsic release, or extensor tendon relocation. Depending on the severity of the arthritic condition, these procedures may be recommended.
The most commonly used technique is the Kirschner wire. Patients are followed up for a minimum of 14 months. Complications associated with this technique include penetration and loss of the available angle for fusion. Headless compression screws are another possible complication.
A newer, more anatomically shaped implant design is being developed. It is made of a bicondylar pyrocarbon total joint that provides some restriction in adduction-abduction motion. These implants are approved for humanitarian use and may be considered in patients with high strength.
In the silicone group, the mean pre-operative PIP joint ROM was 11 degrees/64 degrees. At one year, the mean post-operative ROM was 45 degrees and 54 degrees. Approximately ten per cent of the joints in the group required additional surgery.
The results of the study were analyzed with a statistical analysis of pre-operative risk factors and postoperative assessment of motion. Overall, patients were satisfied with the relief they received from the operation. Nevertheless, several joints in the group showed coronal plane deformities.
A recent study by Ikeda et al investigated the effectiveness of a custom-made splint for the DIP joint. They enrolled 25 patients with DIP joint pain. All of the patients were followed clinically and radiographically for a period of at least 14 months. Compared to the pre-operative VAS pain score, the post-operative VAS score was significantly improved (from 5.5 to 0.85).
Arthritis of the proximal interphalangeal (PIP) joint of the fingers can cause pain and swelling. It is a condition that is very common among rheumatoid arthritis patients.
The PIP joint is located in the middle of the finger. This is the joint that allows the finger to bend. When it is strained, the ligaments that hold the joint together may loosen or stretch.
In some cases, this type of arthritis can cause the finger to bend towards the thumb, referred to as an opera-glass hand. If the joint is not repaired, it can become unstable and swollen. Surgery is sometimes performed to repair it. However, the risk of failure is high.
X-rays can help determine the extent of the damage and the types of fractures that are present. A specialist in arthritis can determine the appropriate treatment for the patient.
Non-operative treatment can include steroid injections and buddy taping. Buddy taping helps to protect the joint and minimize stress on the painful area. Some therapists use special splints to limit the extension of the joint.
An active motion protocol is also recommended. This includes stretching and massage to restore normal alignment of the finger. Although this method is not as aggressive as surgery, it can still improve the function of the finger.
Another option is joint fusion. This method is not as aggressive as joint replacement, but it is a more complex procedure. During the surgery, the surgeon works from the back side of the joint to align and release soft tissues around it.
Surgical methods are also available to treat swan neck deformity of the finger. Typically, this deformity is caused by an over-extension of the PIP joint, or by a rupture of the central extensor tendon.
X-rays of PIP joints may not show damage
X-rays of PIP joints may not show damage for arthritis, particularly if the joint is unstable. Arthroplasty can be considered for severely damaged joints, especially when there is no cartilage cushion. Alternatively, a fusion of both PIP and DIP can improve functional mobility. However, the pre-existing deformity is difficult to correct with implant arthroplasty.
The best treatment for damaged finger joints is arthroplasty. Joint arthroplasty can be performed on digits affected by osteoarthritis, which include the distal interphalangeal (DIP) and proximal interphalangeal (PIP) joints.
Symptoms include soft swelling, hard swelling, stiffness and pain. OA is a degenerative disease that causes the destruction of the joints, most often in the small joints of the hands. A physical examination is helpful, but x-rays can clarify the location and extent of the injury.
An examination should also determine if there are other signs of disease. In inflammatory diseases, antinuclear antibodies, rheumatoid factor and anti-citrullinated peptide antibodies can be used to detect disease.
CT scans can be useful in determining the degree of joint degeneration. They are more sensitive than standard x-rays and can be used to examine bone nodules, synovial cysts and ligaments. High-resolution magnetic resonance imaging is sometimes used to evaluate hand osteoarthritis.
X-rays can be used to determine whether there is a joint fracture or other joint damage. X-rays can be useful for identifying osteophytes, which are bony outgrowths on the edges of joints.
Surgical techniques include plate fixation and tension band wiring. Tension band wiring is the most common technique and uses inexpensive hardware.
Implant arthroplasty is a good option for destroyed PIP joints. During rehabilitation, a functional splint is extended to protect the radial collateral ligament and laterally manipulated during active motion.
Arthritis in the small joints of the hand, such as the DIP joint, can be treated through arthrodesis. However, there are risks associated with this procedure. Some of these include the possibility of deformities, pain and loss of function.
The most common technique for performing arthrodesis is the use of a Kirschner wire. Other methods include headless compression screws. In addition, newer implant designs can limit complications.
An alternative method of PIP arthrodesis is the pyrolytic carbon prosthesis. This treatment offers excellent pain relief and a reduction in deformities. Several studies have reported favourable clinical results. One prospective study investigated the use of a pyrolytic carbon PIP arthroplasty in patients with post-traumatic arthritis. Another group evaluated patients with osteoarthritis.
Clinical evaluation included stability and alignment, as well as motion and pain. Patients were followed clinically and radiographically for at least 14 months. The pain was assessed with a VAS pain score. After the operation, all patients had significant pain relief. Approximately 70% of the PIP joints were pain-free.
A review of 20 out of 29 patients found that the average change in pain scores was a decrease from 100 % to 34 %. The average active mobility of the affected PIP joint increased from 42 degrees to 51 degrees. Deformities were observed in 25 per cent of the joints.
These findings are encouraging, but further studies are needed to improve the design and improve radiologic results. Additionally, additional surveys will be required to determine if new indications for PIP arthrodesis can be developed.
The results of this series indicate the potential for the pyrolytic carbon PIP joint resurfacing arthroplasty to provide similar post-operative ROM and pain relief. Compared to the silicone implant, the pyrolytic carbon arthroplasty showed some improvements in functional DASH scores, but the overall results are inconclusive.