Artificial Finger Joint Replacement

Finger joints are essential for many activities, and arthritis in this area can cause significant joint damage and deformity. Artificial finger joint replacement is a surgical procedure that involves the removal of an arthritic or damaged finger joint and replacement with an artificial prosthesis. 

Anatomy

The hands are made up of 27 bones, which are grouped into carpals, metacarpals and phalanges. Each bone is separated by the articular cartilage, which helps in a smooth gliding movement of the fingers.  Arthritis develops when the cartilage wears-out, resulting in pain, stiffness and inflammation in the joints. Arthritis can affect any joint in the body, but the most commonly affected joints are the small joints of the fingers.

Diagnosis

Your doctor diagnoses arthritis of the finger joint after reviewing your medical history, performing a physical examination, and obtaining X-rays. Additionally, blood tests may also be ordered to confirm the presence of rheumatoid arthritis.

Indications

Artificial finger joint replacement is indicated for patients with arthritis of the fingers. Finger joint replacement is considered if other treatment options fail to relieve the pain and disability.

The surgery is usually reserved for older patients who do not perform heavy labor activities.  Finger replacement implants are not appropriate for younger, more active patients as the implants may loosen or wear out over time.

Contraindications

Artificial finger joint replacement is not recommended in patients with:

  • Poor skin or bone quality
  • An active infection in the affected joint
  • Damage of muscle or tendons
  • Presence of other implants from prior surgeries that would block the insertion or movement of the new prosthetic.

Procedure

The surgery is performed under local or general anesthesia and usually takes about two hours to complete. A cut on the back of the finger joint is made and the soft tissues are spread out to expose the joint. The bone ends that form the finger joint are cut to form a flat surface.  Next, a small cutting tool called a burr is used to create an opening in the bones of the finger joint. Your surgeon will then shape and insert the prosthesis so that it fits snugly in both ends of the finger bone. Nearby ligaments are repositioned to wrap the joint for additional support and the soft tissues are stitched back. The finger is secured in a splint and bandaged.

Postoperative care

Following the surgery, the finger is splinted and bandaged. The splint will help keep the finger straight during the healing process. In some cases, your hand may be placed in an arm-length cast for about three weeks. Avoid excessive use of your operated hand as it can damage the new joint(s). You will have to visit your surgeon five to seven days after the surgery. You will be prescribed medication to control the pain and discomfort. You will have to keep your arm propped up to avoid throbbing and swelling. Physical therapy will also be advised to regain mobility and strength of the finger joint.

Risks and Complications

As with any major surgery there are potential risks involved. Some of the risks and complications following artificial finger joint replacement include

infection, damage to the blood vessels or nerves, loosening of the implants, wear of the implant, and failure of the procedure to relieve pain.

You should call the doctor if your finger becomes red, hot, painful or crooked, or you have sudden severe pain or swelling. 

  • American Academy of Orthopaedic Surgeons
  • American Society for Surgery of the Hand
  • St. Luke's Roosevelt
  • Texas Scottish Rite Hospital for Children
  • NYU School of Medicine
  • North Shore LIJ
  • Pro Medical Newyork