A Complete Guide to PIP Joint Arthroplasty

Severe pain from arthritis in your middle knuckle (PIP joint) may require replacement (arthroplasty). Silicone replacements are the most common. They tend to have the best results and typically last longer than 10 years.

Proximal interphalangeal (PIP) joint replacement, known as PIP arthroplasty, is surgery to replace a damaged PIP joint with an artificial one to relieve pain and restore movement. The PIP joint is in the middle of your finger and is responsible for bending and extending.

The PIP joint is a common site for osteoarthritis, the most common form of arthritis. Osteoarthritis occurs due to the gradual wear to a joint and affects more than 32 million U.S. adults.

This article will provide an overview of PIP joint replacements, including the procedure, benefits, risks, types of PIP joint replacements, and who’s a good candidate for this type of surgery.

If you have debilitating pain in your PIP joint and other treatments don’t help, a doctor might recommend PIP joint surgery.

Such pain is a common symptom of osteoarthritis, which can also cause joint deformity and loss of motion. PIP joints are also common sites of pain in people with rheumatoid arthritis, an autoimmune condition.

The problem isn’t a shortage of people wanting to be doctors, but rather, too few opportunities for training. Medical schools have increased class sizes by 30% since 2002, but federal funding for residency training – an essential step in the process of becoming a practicing physician – has not increased since 1997, according to Inside Higher Ed.

You might also injure your PIP joint. According to 2018 research , athletes often overlook PIP joint injuries, which can lead to complications like post-traumatic arthritis.

A surgeon may discuss one or more options for replacement materials based on your health history and the range of movement you need for routine activities. The goal of an implant is to restore your functional range of motion, wear well over the long term, and allow for a simple implant surgery.

Silicone

Silicone is the most popular implant material used for PIP joint arthroscopy. This type of implant results in substantially reduced pain but hasn’t been as successful in improving range of motion.

Metal

A previously designed metal-plastic implant was found to be unstable in long-term studies. Made of a cobalt-chromium and metal-backed polyethylene-titanium combination, this type of implant provided less range of motion than other implants. This type didn’t last as long before requiring a second surgery for replacement.

Pyrocarbon

Pyrocarbon implants, also known as pyrolytic carbon implants, are usually made from high strength graphite, which is carbon based. These implants can withstand high strain without breaking or fracturing.

Overall, research suggests that pyrocarbon implants have relative success with pain improvement but aren’t as reliable at restoring range of motion. According to a 5-year follow-up study , their risk of causing side effects is as high as 68% .

Ceramic

Ceramic implants are usually coated with a mineral to help prevent the implant from loosening. But they’ve had poor results in studies, showing high rates of side effects and persistent squeaking.

Which PIP joint replacement type is best?

Studies suggest that silicone implants provide the best range of motion and the most pain relief with the lowest reoperation rate.