Finger joint replacement (arthroplasty) is an operation to replace a damaged finger joint with an artificial implant, most commonly a silicone spacer. It is performed for painful, stiff finger joints affected by rheumatoid or osteoarthritis.
An incision is made over the affected joint (most commonly the metacarpophalangeal or proximal interphalangeal joint). The damaged joint surfaces are removed and a silicone or pyrocarbon implant is inserted. The ligaments and tendons are repaired around the implant. The operation takes 30–60 minutes per joint.
Surgery is recommended for painful, deformed, or stiff finger joints that significantly limit hand function and have not responded to medical management. It is most commonly performed for rheumatoid arthritis of the MCP joints.
Disease-modifying medication for rheumatoid arthritis, hand therapy, splinting, corticosteroid injection, and adaptive equipment.
Hand therapy assessment. Rheumatoid medication may need adjustment. Multiple joints can be replaced in one operation.
The aim is to relieve pain, improve finger alignment, and restore functional grip. The replacement provides a stable, pain-free arc of movement rather than a fully normal joint. Patient satisfaction is generally high for pain relief and improved appearance.
The replaced joint has a functional arc but not full normal movement.
Hand swelling for several weeks.
The fingers may drift again over time, particularly in rheumatoid arthritis.
Silicone implants can fracture over time. This may or may not cause symptoms and may require revision.
The implant may shift position.
Joint infection requiring implant removal.
Weakened tendons in rheumatoid disease may rupture.
Regional arm block, general, or local anaesthesia.
Hand therapy is essential and begins within the first week. A dynamic splint may be worn for several weeks to guide the fingers into proper alignment. Light use of the hand at four to six weeks. Full recovery takes three to six months.
Regular reviews with hand therapy. Surgeon review at six weeks and three months.
Silicone implants typically last 10–15 years. Some fracture earlier but may remain asymptomatic. Pyrocarbon implants may last longer.
Yes, multiple MCP joints are commonly replaced in a single operation.