Finger joint denervation in hand osteoarthritis: Indications, surgical techniques and outcomes. A systematic review of published cases

Gandolfi, Silvia; Carloni, Raphaël; Mouton, Jordane; Auquit-Auckbur, I.

doi:10.1016/j.hansur.2020.02.005

Cited by 14 publications

(7 citation statements)

References 44 publications

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“…Previous studies that evaluated selective joint denervation of the hand and knee demonstrated adequate satisfaction rates and outcomes in alleviating pain. 3,5,9,15,19,22 The midterm outcomes reported by patients in the present study were encouraging, with an 80.8% satisfaction rate with the surgery helping to alleviate dorsal midfoot pain symptoms, 84.6% who would repeat the surgery, 83.8% who would recommend the surgery to a friend, and 91.7% who reported dorsal midfoot pain relief in the first 6 months following surgery. At an average follow-up of 35.1 months, DPN neurectomy appeared to work and was effective at providing dorsal midfoot pain relief.…”

Section: Discussionsupporting

confidence: 54%

Patient Satisfaction and Pain Relief After Deep Peroneal Nerve Neurectomy for Midfoot Arthritis: A Preliminary Short Report

et al. 2023

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Background: The deep peroneal nerve (DPN) plays a role in afferent nociceptive dorsal midfoot joint pain perception. DPN neurectomy for treatment of symptomatic dorsal midfoot osteoarthritis allows early mobilization and weightbearing. The purpose of our study was to evaluate the patient satisfaction and pain relief after DPN neurectomy for treatment of chronic dorsal midfoot pain due to osteoarthritis. Methods: In this retrospective, IRB-approved, questionnaire-based study, we evaluated 48 patients (55 feet) with an average follow-up of 35.1 (range, 16-51) months who underwent DPN neurectomy at our institution between September 2017 and February 2021. There were 38 women and 10 men, 41 unilateral (22 right, 19 left) and 7 bilateral procedures, with an average age of 67.8 (range, 35-88) years at the time of surgery. A questionnaire that included questions regarding postsurgical dorsal midfoot pain relief, surgical result satisfaction, and current functional limitations was administered via telephone. Demographic information, patient responses, and complications were recorded. Results: Of the 48 patients, 80.8% were satisfied with the result of the surgery in relieving their dorsal midfoot pain, 84.6% would repeat the surgery under the same circumstances, 83.8% would recommend the surgery to a friend, 10.4% reported they wish they had undergone arthrodesis, 91.7% reported pain relief in the first 6 months, and 55.6% reported current activity limitations. Six feet (10.9%) underwent a second procedure with an average postoperative time of 20.5 (range, 1-36) months. Complications included 1 hematoma and deep wound infection, 1 DPN neuroma and superficial peroneal nerve entrapment, and 4 patients with inadequate pain relief. Conclusion: In this cohort, DPN neurectomy appeared to be a reasonable surgical alternative to arthrodesis for the management of chronic dorsal midfoot pain due to midfoot osteoarthritis after failed nonoperative management. Level of Evidence: Level IV, retrospective case series.

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Section: Discussionsupporting

confidence: 54%

Patient Satisfaction and Pain Relief After Deep Peroneal Nerve Neurectomy for Midfoot Arthritis: A Preliminary Short Report

et al. 2023

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“…The indications are comparable for the different joints: degenerative or post-traumatic painful osteoarthritis when satisfactory reconstruction is not possible or when non-surgical conservative treatment is exceeded [11].…”

Section: Introductionmentioning

confidence: 99%

“…In case of osteoarthritis (OA) with preserved motion, articular denervation may be an effective alternative to arthroplasty or arthrodesis, to reduce or to treat a painful discomfort [11].…”

Section: Introductionmentioning

confidence: 99%

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Innervation of digital joints: an anatomical overview

et al. 2021

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Introduction The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical feasibility of a selective and efficient denervation of the digital joints. Materials and methods A study of 40 distal interphalangeal (DIP), 40 proximal interphalangeal (PIP), 50 metacarpophalangeal (MCP), 10 interphalangeal (IP) of the thumb, and 10 trapezo-metacarpophalangeal (TMC) joints was performed on ten hands. Under magnification and a proper surgical approach, we collected the course, the source origin, the number of articular nerve branches, and their caliber. Results In total, 118 nerve branches arising from the proper palmar digital nerves were found on 10 DIP of each dissected long finger (n = 40). A total of 226 nerve branches were found on 10 PIPs of each long finger (n = 40), of which 204 branches (90.3%) had a palmar origin. Dorsal innervation was found for the ring and little finger, originating from the dorso-ulnar digital nerve. 212 branches were found on 10 MCP of long fingers (n = 40), including 87 branches of palmar origin (41.1%), 107 branches of dorsal origin (50.4%), and 18 branches of the motor branch of the ulnar nerve (8.5%). 42 articular branches directed to the TMC joint (n = 10) were found. 13 branches (31%) originated from the anterior sensory branch of the radial nerve, 13 branches (31%) originated from the lateral cutaneous nerve of the forearm, 5 branches (12%) originated from the palmar cutaneous branch of the median nerve, and 11 (26%) branches originated from the thenar branch of the median nerve. The involvement of the sensory anterior branch of the radial nerve was always present for the innervation of each TMC. Discussion and conclusion Our research shows that finger joints receive their primary innervation from small branches of the digital nerves with the exception of the MCP joint and the TMC joint. To obtain an efficient and a selective digital denervation for articular pain relief, it is necessary to plan the best surgical approach and it is crucial to recognize the articular nervous branch localization and source.

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“…Nevertheless, recent systematic reviews on finger joint and wrist joint denervation show improved pain, increased grip strength, high satisfaction, and a high return-to-work rate. 9,10 However, these reviews give an observational description of the current data, and meta-analysis is missing to provide a solid conclusion.…”

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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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Finger joint denervation in hand osteoarthritis: Indications, surgical techniques and outcomes. A systematic review of published cases

Cited by 14 publications

References 44 publications

Patient Satisfaction and Pain Relief After Deep Peroneal Nerve Neurectomy for Midfoot Arthritis: A Preliminary Short Report

Patient Satisfaction and Pain Relief After Deep Peroneal Nerve Neurectomy for Midfoot Arthritis: A Preliminary Short Report

Innervation of digital joints: an anatomical overview

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

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