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Introduction: In hand joint arthroplasty, or finger joint replacement, the damaged portions of the finger bones are removed and replaced with artificial components, and sometimes other tissues belonging to the patient are used to resurface the finger joints. Hand joint arthroplasty is most often performed on the second joint from the fingertip, the third joint from the fingertip (large knuckle), and the thumb joint. 

Function: To relieve pain as well as to restore and maintain function of the hand and fingers and to help improve range of motion. 

History of Injury: Although some people may need hand arthroplasty after an injury, more often, the procedure is performed on people who are dealing with the effects of rheumatoid arthritis or osteoarthritis.

Diagnosis: Your orthopedic surgeon will ask you questions about your general health as well as your hand and finger pain and how it is impacting your ability to function. He or she will also perform a physical exam to assess the strength, range of motion, and condition of your hand and fingers. To better understand the damage, your surgeon will have X-rays taken of your hand. 

Treatment: Hand joint arthroplasty if your condition is severe or a nonsurgical option if your orthopedic surgeon recommends it.

Initial: Before recommending hand joint arthroplasty, your orthopedic surgeon may suggest other treatments, such as taking anti-inflammatory medications, steroid injections, or wearing a splint, in addition to avoiding activities that could make your symptoms worse.

Long Term: If nonsurgical treatments are not helpful or no longer relieve pain, hand joint arthroplasty could be a good option for you.

Indications for Surgery: If you have rheumatoid arthritis or osteoarthritis and your hand pain is interfering with your daily life—even while you are resting—you may be a good candidate for hand joint arthroplasty. If you have post-traumatic arthritis due to an injury, you may also benefit from hand joint arthroplasty.

Surgery: Hand joint arthroplasty is an outpatient procedure. After you are given anesthesia, your orthopedic surgeon will make an incision on the back of your hand near the affected joint. The tendons over the area are moved to access the joint. The damaged ends of your finger bones will then be removed to make room for the artificial joint. Next, small holes are created in your finger bones in order to place the artificial joint. The stems of the joint are then permanently secured in place into the canals of the finger bones, the tendons are returned to their proper position, and the incision is closed.

Post-Operation: You will go to a recovery room where you will be monitored. During the first few weeks while your bones heal, you will need to wear a splint, keep your hand elevated to limit swelling, and follow your orthopedic surgeon’s instructions for performing finger and hand exercises to help you heal properly. 

Rehabilitation: After your splint is removed, you will need to follow the exercises your surgeon or physical therapist has instructed you to do to help your finger(s) and hand heal properly, which may take approximately six to twelve weeks. 

Risks and Complications: As with any surgery, there is a risk of infection or blood clots. You should also avoid heavy lifting or hard manual labor.

Summary: You should seek out an experienced orthopedic surgeon to perform your hand joint arthroplasty. This clinician should not only be skilled at performing the surgery but also have the ability to accurately assess the extent of the damage prior to surgery.