Finger replacement surgery for arthritis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Many types of inflammatory arthritis affect the tendons and joints of the wrist and hand. The joints and the supportive structures around it undergo severe damage.

This can lead to severe deformities of the fingers.

The diseases most likely to lead to finger joint replacement are rheumatoid arthritis, psoriatic arthritis, pseudogout, and inflammatory osteoarthritis. Fortunately, with newer medicines available, the need for these types of radical procedures has decreased.

Surgery for the reconstruction of deformed arthritic joints is carried out in an in-patient setting using regional or general anesthesia and the procedures may take two to five hours depending on the degree of difficulty.

Special instruments are used to remove the destroyed bone and joint.

Channels in the middle of the shafts of the fingers are prepared for the stems of the implants. Trial implants will be placed in each joint space to confirm the appropriate positioning and size. The new implants will then be placed in each joint.

After joint replacement surgery, a therapy program will be started. Patients undergoing these reconstructive procedures also undergo specialized splinting and a long therapy course in order to achieve the best possible result.

The end result will not be a normal hand. The goal of surgery is to improve the status of the hand.

As with other major procedures of the wrist and hand, there can be complications of surgery.

Incision separation or wound breakdown is more common in rheumatoid arthritis patients than in patients without rheumatoid disease. Infections can also complicate the recovery process. On rare occasions the implants may dislocate during the postoperative therapy and surgical relocation may be necessary.

Late problems after finger joint replacement surgery include bending or fracturing of the implants which may lead to the return of finger deformities. Joint revision and implant replacement may be required for those patients.

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