Efficacy of joint denervation for degenerative disease of the joints in the hand: a review.

Osteoarthritis of the fingers and wrist, whether primary or secondary, is the most common degenerative disease. Its incidence is increasing due to the aging of the population. Most of the patients can be treated conservatively with good effect, but when conservative treatment fails, surgical intervention is considered. Essentially, there are 2 types of operations for this disease - radical (bone excision, arthrodesis, arthroplasty with an implant), and non-radical (joint denervation). Denervation of the joints has obvious advantages such as non-compromising the joint anatomy, preservation of range of motion, avoiding of an implant and low rate of complications. Denervation can be offered to younger patients, whatever their functional demands. Preservation of the bony anatomy does not preclude any further, more radical surgical interventions. This article presents a comprehensive information about methods of denervation of particular joints within the hand and their effectiveness in osteoarthritis. The current literature provides convincing evidence that denervation is a reliable and reproducible surgical technique for painful osteoarthritic conditions of the hand. It should be considered in patients presenting with painful joints which are still mobile, regardless the initial aetiology.