Joint replacement or arthroplasty is a procedure to replace a damaged joint surface with an implant which still allows some movement in the joint. In the hand, it is usually done for the metacarpophalangeal joints (knuckle) or the proximal interphalangeal joints (first finger joint), although other joints can be replaced. The joint damage can be due to arthritis, trauma or infection. If the damage is from infection, this must be completely resolved before joint replacement. Joint replacement can relieve pain in an arthritic joint where the surface has been worn away or is very irregular.
The joint replacement or implant used can be silicone or metal. I use silicone implants more frequently than metal implants. It is sized according to the size the joint it is replacing and the size of the bones on either side. There will be a splint or cast to protect the area initially and postoperatively an exercise or rehabilitation programme will start. This gradually increases the movements and activities of the replaced joint and gradually decreases the amount of time the splint needs to be worn.
Most light activity can be resumed after six weeks but heavier work may not be allowed for up to twelve weeks postoperatively.