Prosthetic replacement of the proximal interphalangeal joints is an operative treatment for osteoarhtritis, to preserve the range of motion and the function of the hand. The purpose of this study is to detect the differences regarding pain and function between a silicone implant using a volar approach and a resurfacing implant, placed through a dorsal approach. Patients were reviewed clinically and scored. We found no significant differences in outcome between the two types of implants. However, the complication rate in the resurfacing group was significantly higher. Also, the economic cost of both implants was significantly different. The resurfacing implants were more expensive than the silicone implants.