Silicone arthroplasty of the proximal interphalangeal joint is a useful procedure. Silicone arthroplasty of the proximal interphalangeal joint is performed in patients with posttraumatic or inflammatory osteoarthritis of the proximal interphalangeal joint and patients with chronic conditions, such as a flexion contracture or swan neck deformity. Surgeons must consider the vocation, age, and functional demands of each patient to determine if they are a good candidate for silicone arthroplasty compared with surface replacement arthroplasty or arthrodesis.