Finger Joint Arthroplasty for PIP and MCP Arthritis
Arthritis of the small joints of the fingers can cause pain, swelling, stiffness, deformity and loss of hand function. It may affect the proximal interphalangeal (PIP) joints, which are the middle joints of the fingers, or the metacarpophalangeal (MCP) joints, which are the knuckle joints. When arthritis becomes advanced, everyday activities such as gripping, pinching, writing, using tools and performing fine hand tasks can become difficult.
Treatment Options
The traditional surgical treatment for severe small joint arthritis has often been fusion. Fusion is a reliable operation for pain relief and remains an excellent option in many situations, particularly when stability and strength are more important than movement. However, fusion permanently removes motion from that joint. While this can be very effective for pain, it may alter the way the finger moves and can affect more complex hand function.
Joint Arthroplasty
For appropriately selected patients, small joint arthroplasty offers a motion-sparing alternative. PIP and MCP joint replacements aim to relieve pain while preserving or improving joint movement, alignment and more natural finger function. This can be particularly valuable for patients where maintaining motion is important for grip, dexterity and daily activities.
Surgical Considerations
Modern finger joint arthroplasty can be performed using different types of implants depending on the joint involved, the pattern of arthritis, bone quality, soft tissue stability and the patient’s functional needs. In the right patient, these procedures can provide very good pain relief, improved alignment and more natural kinematic hand function compared with fusion.
Risks and Expected Outcomes
Dr Ye performs PIP and MCP joint arthroplasty for suitable patients with small joint finger arthritis. He has a particular interest in motion-preserving reconstructive surgery of the hand. As with all joint replacement surgery, the outcome depends on appropriate patient selection, careful surgical technique and realistic expectations. Possible risks include stiffness, swelling, instability, dislocation, implant loosening, implant wear, infection, fracture and the possibility of revision surgery or conversion to fusion. However, in selected patients, PIP and MCP joint arthroplasty can be a valuable option for relieving pain while preserving useful finger motion.
Individualised Treatment Planning
Dr Ye will discuss whether arthroplasty or fusion is more suitable based on the joint involved, the severity of arthritis, deformity, functional goals, work demands and the expected rehabilitation.