Joint Denervation in the Digits: Technique and Patient Satisfaction

BACKGROUNDTraditional approaches to treating painful osteoarthritis of the fingers include arthrodesis and arthroplasty. Although highly effective for pain control, arthrodesis sacrifices joint motion and can be complicated by nonunion, malunion, and infection.Implant arthroplasty preserves motion but is likewise subject to complications—particularly at the level of the proximal interphalangeal joint. In contrast, finger joint denervation is a simple outpatient procedure that maintains joint motion. In this study, we describe our surgical techniques for joint denervation and review our survey of patient satisfaction. METHODSA retrospective review was performed of all patients undergoing finger joint denervation for osteoarthritis at our institution from 2012 to 2014. Each patient was contacted by phone and asked to rate their pre- and postoperative pain and function.Patients were also asked about any complications experienced and if they would choose to undergo the operation again. RESULTSOver the 2-year period, 12 patients underwent denervation of 23 joints. Of the 12 patients in the study, 11 undergoing 22 joint denervations were available for our survey. Patient-reported pain scores fell from a median of 5/5 preoperatively to 0/5 after recovery (P < 0.001). Perceived hand function improved from a preoperative reported median of 2/5 to a postoperative median of 5/5 (P < 0.001). Complications were few, and 9 of 11 patients said they would choose to have the operation again. CONCLUSIONSJoint denervation is a safe and effective treatment modality for osteoarthritis of the digits, resulting in good pain relief and high patient satisfaction with low complication rates.