We compared the 2 year outcomes after proximal interphalangeal joint surface replacement in 68 joints with severe (>15°) preoperative longitudinal axis deviation and 50 joints without (<5°) preoperative deviation. Patients in both groups had a mean preoperative brief Michigan Hand Outcomes Questionnaire score of 47 and had similar 2 year scores of 72 (95% CI 68–77) (severe deviation) and 70 (95% CI 65–76) (no deviation). Pain, proximal interphalangeal joint range of motion, grip strength and complications did not differ between the groups at 2 years. Ninety per cent of the severely deviated joints had a deviation of less than 15° at follow-up. The revision rates were 5.9% and 1.8% for deviated and non-deviated joints, respectively. We recommend a surface replacing implant to correct severe preoperative axis deviations of the proximal interphalangeal joint, but the risk of revision surgery needs to be considered.
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