Hand and Finger Joint Replacements
Hand, Wrist & Finger Specialist Care
Hand and finger joint replacement is a specialized surgical procedure for patients whose finger joints are severely damaged and painful. It is most often recommended for people with arthritis in their finger joints, such as wear-and-tear osteoarthritis, inflammatory rheumatoid arthritis, or arthritis that develops after injury.
Indications
Causes like previous finger trauma and joint deformities can lead to painful arthritis requiring replacement.
In each case, the goal is to remove the worn joint surfaces and relieve pain while preserving as much finger motion as possible.
- Osteoarthritis: Degenerative joint disease that causes the cartilage in the hand and finger joints to wear down, leading to pain and limited mobility.
- Rheumatoid arthritis: An autoimmune disorder that results in chronic inflammation and joint damage, leading to joint deformities and functional impairments.
- Post-traumatic arthritis: Arthritis that develops after a previous hand or finger injury, causing long-term joint damage and pain.
- Joint deformities: Severe joint deformities that interfere with hand function and mobility.
Joints that can benefit from replacement
Not all finger joints can be replaced, but the middle and base joints of the fingers often can.
These replacements can greatly improve finger motion and hand grip strength. In contrast, the fingertip (distal interphalangeal, or DIP) joints are very small and implants do not work well there; they are usually fused (joined with no motion) if treatment is needed.
- Finger proximal interphalangeal joints (PIPJs): Replacing the PIPJs can significantly improve finger mobility and function in cases of arthritis or joint damage.
- Finger metacarpophalangeal joints (MCPJs): MCPJ replacements can restore hand function and grip strength affected by arthritis or joint deformities.
- Finger distal interphalangeal joints (DIPJs): In some cases, a fusion procedure may be more reliable for the DIPJ instead of a joint replacement.
Types of joint replacements
The implants must mimic natural cartilage and allow smooth motion.
The implants must mimic natural cartilage and allow smooth motion. Common options include silicone (silastic) implants, pyrocarbon implants, and metal-on-polyethylene implants. Silicone implants are flexible and often linked across the joint.
Pyrocarbon implants are carbon-coated devices that have cartilage-like properties. Metal-on-polyethylene implants use a metal cap that glides against a smooth plastic surface. Each type has advantages in durability and movement.
- Silicone (silastic) implants: Flexible silicone joints that provide stability and motion.
- Pyrocarbon/metal-poly implants: Carbon-coated or metal components that articulate with plastic liners, designed to closely mimic natural joint movement.
Longevity of implants
Over the years, implants can loosen, fracture, or wear down under heavy use. When an implant fails, it can often be revised or replaced. In some cases where replacement is no longer possible, the surgeon may recommend fusing the joint to eliminate pain.
Durability
Most finger joint implants are designed to last for many years, often providing reliable pain relief and improved function for a decade or more. The exact longevity depends on several factors, such as the type of implant used, the patient’s age, and their daily activity levels.
- Typical lifespan: Many patients enjoy 10–15 years of pain relief before implants show signs of wear.
- Activity matters: Heavy use of the hand can accelerate wear and tear on the implant.
Implant Failure
Despite improvements in design, implants may eventually fail. Failure does not mean sudden collapse, but rather gradual problems that can develop over time. Common issues include loosening (where the implant no longer stays firmly anchored in the bone), wearing down of the implant materials, or fracture of the implant itself. Symptoms of implant failure may include returning pain, swelling, instability, or reduced range of motion.
- Possible issues: Loosening, wear, or fracture of implant components can develop over years.
- Management: Failed implants can often be revised; if not, joint fusion offers a reliable pain-relief option.
Rehabilitation
After surgery, rehabilitation is crucial for a successful outcome. A hand therapist will guide you through exercises to regain strength and flexibility in your fingers and hand. Early movement under professional supervision helps prevent stiffness and rebuild fine motor control.
Additionally, customized splints or ring splints may be used to protect the joint and maintain alignment during healing. Adhering to the rehab plan helps restore function and range of motion more quickly.
- Hand therapy: Working with a hand therapist on strength, flexibility, and functional exercises is essential after joint replacement.
- Splinting: You may use a custom finger splint (e.g. an “Oval-8” ring splint) to support the joint and prevent deforming forces while it heals.
The primary benefit is significant pain relief in the affected finger. By removing the damaged joint surfaces and inserting an implant, pressure and friction are eliminated. Most patients notice that arthritis pain is greatly reduced. Improved hand function is also possible – even if the joint’s motion doesn’t change dramatically, reducing pain allows you to use your hand more effectively.
Hand and finger joint replacements with Dr Oscar Brumby-Rendell
Dr. Oscar Brumby-Rendell is an expert hand and upper limb surgeon based in Adelaide. He is a founding director of the Adelaide Shoulder & Upper Limb Clinic and specialises in the shoulder, elbow, wrist and hand.
Dr Oscar has advanced fellowship training, including an international orthopaedic fellowship, and uses cutting-edge techniques such as computer-navigated joint replacement surgery. He is committed to personalized, patient-focused care and continually advances his skills through research and teaching to ensure the best outcomes for his patients.
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