Introduction

Rheumatoid arthritis and osteoarthritis are the most common arthritic conditions affecting the fingers, particularly the joints known as MCP (the joints at the beginning of the finger) and PIP joints (the joints between the first two bones of each finger). Arthritis forms large boney bumps and destroys the smooth joint surfaces (cartilage). Rheumatoid arthritis tends to erode the bone and cartilage of the MCP joints (the joints which join the fingers to the hand) and the PIP joints and may produce severe deformities of the fingers.

If you suffer from arthritis of the finger, your joints may become so painful, deformed, or poorly functional it is almost impossible to use your hands for your everyday activities. The good news is there are artificial joints that may be used to surgically replace your damaged finger joints.

Ask your doctor if finger replacement surgery is the right option for you. Not all arthritic finger joints are good candidates for replacement. The best surgical options for you will be made based on the severity of your arthritis, your general medical condition, which joints are affected, and the experience and preferences of your surgeon.

Before the Surgery

Once you have made the decision to have finger joint replacement surgery, your doctor may order some tests to make sure you are healthy enough to have the operation. This may include blood tests, X-Rays, or an electrical study of your heart called an EKG. There may also be some blood tests to make sure all of the chemicals in your body are working properly.

Finger replacement surgery can be done as either an in-patient or out-patient procedure. This depends on how many joints need to be replaced in your hand, how long the procedure will take, how long your surgeon estimates you may be in pain after the surgery, and other special patient considerations. You will need to discuss all these details with your surgeon.

An important part of surgery is anesthesia—the medicine a doctor gives you to put you to sleep (general) or make certain parts of your body numb (regional). In either case, extra local anesthesia may be used at the end of the procedure to reduce any discomfort after the operation.

The Surgery

Finger surgery will involve cuts on the back of the hand or fingers to show the joint—the cuts will be made so they preserve as much of the normal support issues as possible. In some cases, the incision will be made on the palm side of your hand if you are having a PIP joint replaced.

Your surgeon will remove the damaged portions of the joints along with any arthritic boney spurs. He or she will then prepare the canals in the middle of both of the bones that make up the joint so that they can be ready for the placement of the stems of the implant.

When your surgeon has prepared the joint space and opposing bone canals, trial replacement joints will be used to find the correct size for each joint. The stems are then inserted into the canals of the bones on each side of the joint.  

When the correct size has been determined, the permanent implant is then inserted and the surgeon will make sure it moves properly. The surgeon will close the soft tissues around the joint then close the overlying skin and your hand will be dressed in a large dressing involving the fingers, hand and wrist.

After the Surgery and in the Hospital

After the surgery, you will be asked to keep the hand elevated during the first few post-operative days to prevent swelling. You may or may not be kept in the hospital depending on the number of joints replaced and any other procedures that may have been done along with your replacement procedures. A typical hospital stay can last one to two days.

Pain medications will be prescribed and you may need antibiotics if your health care team thinks infection is a threat.

Leaving the Hospital

At home, you need to be wary of a fever or signs of a wound infection such as new pain at the surgical site or a foul smell from your bandage. If you have any concern, you should notify your surgeon immediately.

Other complications that may occur after finger joint replacement surgery are failure of the implant due to fatigue, wear or over-loading. Also, some patients may have a reaction to silicone implants. If you experience problems after your surgery, your should contact your physician.

This first dressing will be removed after several days and will be replaced with a lighter dressing. You can expect the stitches to be removed 10 days to two weeks after surgery.

Therapy will be started in one to three weeks at the discretion of your surgeon and will involve the use of special splints worn for up to three months. You may need to visit the rehabilitation facility fairly frequently in order to maximize the result of your joint replacement procedure.

For more complete information about finger replacement surgery, visit www.jointreplacement.com  or www.neuflex.com.