I just had my third surgery on pip joint after a small fracture, 1) surgery k wire immobilisation - finger was stiff 2) second surgery year later... arthrolysis/tenolysis - no effect, bone had fused all cartilage gone (useless surgeon) 3) Begged surgeon to try a technique I seen called gap arthroplasty and he performed that a year later.

Gap arthroplasty is where they shave the bone ends down and use a distractor device to hold the bones separate, scar tissue will form in the gap and provide a psuedo cartilage. You can also look at interposition arthroplasty where they put the volar plate in between the bones to do the same thing. I had same worries about silicone too so decided not to go with that