Denervation for Proximal Interphalangeal Joint Osteoarthritis

Jiménez, Isidro; Marcos-García, Alberto; Muratore, Gustavo; Caballero-Martel, J.; Medina, Jorge

doi:10.1016/j.jhsa.2019.07.012

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…El tratamiento de las fracturas intrarticulares de los dedos suele ser muy complejo, especialmente en aquellos casos que cursan con gran conminución, falta de stock óseo y defecto del cartílago articular. 1 Se han publicado muchos procedimientos para intentar restaurar la anatomía y la funcionalidad de la articulación interfalángica proximal, como la artroplastia por interposición de Eaton, 7 la desnervación articular, 8 el reemplazo articular artificial, 9,10 el trasplante articular parcial no vascularizado del pie 11 o de la mano (hueso ganchoso, por ejemplo) 12 o el trasplante vascularizado libre de una articulación del dedo del pie para la mano. 13,14 También, en casos de secuelas, puede realizarse la artrodesis interfalángica proximal con el fin de mejorar la función del dedo afectado, pese a bloquear la movilidad de la articulación en cuestión.…”

Section: Discussionunclassified

Artroplastia interfalángica proximal de dedo de la mano con doble injerto osteocondral de costilla. Reporte de un caso y descripción de la técnica quirúrgica

Gardenal

Carcuro

Bichara

et al. 2021

Rev. Asoc. Arg. Ort. y Traumatol

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Se presenta el caso de un hombre de 27 años con una lesión grave articular interfalángica proximal en el dedo anular de la mano derecha, provocada por un proyectil de arma de fuego, que fue tratada con doble injerto osteocondral de costilla. Tenía una fractura expuesta y déficit de stock óseo y cartilaginoso tanto en la primera como en la segunda falange. Luego de la limpieza inicial, a las 3 semanas, se realizó una artroplastia interfalángica proximal con doble injerto osteocondral de costilla y fijador externo distractor de Suzuki. Se describe con detalle la técnica quirúrgica. A las 10 semanas posoperatorias, la flexión activa interfalángicaera de 75° y la extensión activa, de -15°, con articulación estable. Alta laboral a los 3 meses de la cirugía, sin dolor y un puntaje DASH de 14,2. Las radiografías mostraron la incorporación de los injertos, sin reabsorción y con una articulación congruente. Se valora la ventaja de esta técnica en cuanto a la escasa morbilidad para la zona dadora y la versatilidad para las reconstrucciones con defectos articulares. El resultado funcional temprano subjetivo y objetivo fue satisfactorio. No se pueden descartar complicaciones futuras.

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Section: Discussionunclassified

Artroplastia interfalángica proximal de dedo de la mano con doble injerto osteocondral de costilla. Reporte de un caso y descripción de la técnica quirúrgica

Gardenal

Carcuro

Bichara

et al. 2021

Rev. Asoc. Arg. Ort. y Traumatol

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“…Again, the specific nerves that were dissected varied. Servasier et al 29 stated they dissected all joint afferents, Madsen et al 30 dissected the articular branches of the radial, ulnar and dorsal digital nerves, Jiménez et al 31 dissected the palmar articular nerve, and the articular branches of the common and dorsal digital nerves, and Braga-Silva and Calcagnotto 32 dissected the branches from the palmar digital nerves.…”

Section: Pipj Denervationmentioning

confidence: 99%

“…The study by Jiménez et al 31 stood out, having a population with a lower median age (52 years). The percentage of female participants was around 60%-75% in most studies, with a very high percentage (98%) in the study by Servasier et al, 29 and a very low percentage (36%) in the study by Jiménez et al 31 Most studies presented baseline pain scores, often on a 0-10 Numeric Rating Scale (NRS). Average baseline pain scores varied from 7.5 to 8.7 on NRS.…”

Section: Baseline Characteristicsmentioning

confidence: 99%

Surgical denervation as a treatment strategy for pain in hand osteoarthritis: a systematic literature review

Meulen

Stadt²,

Claassen³

et al. 2023

RMD Open

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ObjectiveSurgical denervation has been proposed as a treatment for pain in hand osteoarthritis (OA). This review aimed to summarise the available evidence and to propose a research agenda.MethodsA systematic literature search was performed up to September 2022. Two investigators independently identified studies that reported on denervation for OA of the proximal interphalangeal, distal interphalangeal, metacarpophalangeal or carpometacarpal joints. Quality of studies was assessed and study characteristics, patient characteristics, details of the surgical technique and outcomes of the surgery were extracted.ResultsOf 169 references, 17 articles reporting on 384 denervations in 351 patients were selected. Sixteen case series reported positive outcomes with respect to pain, function and patient satisfaction. One non-randomised clinical trial reported no difference in outcome when comparing denervation of the first carpometacarpal (CMC I) joint to trapeziectomy. Adverse events were frequent, with sensory abnormalities occurring the most, followed by the need for revision surgery. All studies had significant risk of bias.ConclusionSurgical denervation for pain in hand OA shows some promise, but the available evidence does not allow any conclusions of efficacy and higher-quality research is needed. Techniques should be harmonised and more data regarding how denervation compares to current usual care, other denervation methods or placebo in terms of outcomes and adverse events are needed.

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“…The technique of denervation of the proximal interphalangeal joint is performed equal to the volar dissection of the metacarpophalangeal joint, a Bruner style incision is made, and the radial and ulnar digital nerve are identified just distal from their origin of the common digital nerve. [43][44][45] Both nerves are mobilized circumferentially. Through this approach, the dorsal digital branches are divided by lifting them off the paratenon of the extensor mechanism (Fig.…”

Section: Denervation Of the Proximal Interphalangeal Jointmentioning

confidence: 99%

Denervation of the Joints of the Hand and Wrist: Surgical Techniques and a Systematic Review with Meta-Analysis

Tieman

Duraku

Oest

et al. 2021

Plastic &Amp; Reconstructive Surgery

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hronic pain of the joints of hand and wrist can be debilitating and lead to significant impairment in daily life. Symptomatic hand and wrist osteoarthritis alone affects approximately 5 percent of all adults worldwide and has a prevalence as high as 20 percent in elderly patients. 1 First-line treatment for chronic hand and wrist joint pain consists of analgesics, hand therapy, splints, corticosteroid injections, or a combination of these techniques. [2][3][4] If these nonoperative measures are insufficient, more rigorous surgical secondline treatments are available such as arthrodesis, resection, or joint replacement. 5,6 All these procedures have a lengthy rehabilitation period and can decrease the range of motion of the affected joints.An elegant intermediate solution can be denervation of the joint. Joint denervation has been described for several joints, starting in 1933 for the hip joint by Tavernier. 7 Wilhelm popularized the joint denervation technique for the hand and wrist. 8 The focus of the treatment lies in the dissection of the articular branches innervating

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Denervation for Proximal Interphalangeal Joint Osteoarthritis

Cited by 8 publications

References 17 publications

Artroplastia interfalángica proximal de dedo de la mano con doble injerto osteocondral de costilla. Reporte de un caso y descripción de la técnica quirúrgica

Artroplastia interfalángica proximal de dedo de la mano con doble injerto osteocondral de costilla. Reporte de un caso y descripción de la técnica quirúrgica

Surgical denervation as a treatment strategy for pain in hand osteoarthritis: a systematic literature review

Denervation of the Joints of the Hand and Wrist: Surgical Techniques and a Systematic Review with Meta-Analysis

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