Before considering surgery painful finger joints may respond to painkillers applied as creams or taken by mouth. Pain killing injections (steroids) may be given directly into joints in clinic when you see a hand specialist at The Horder Centre. If pain persists despite the use of painkillers it may be time to think about an operation which offers long term pain relief in at least 90% of cases. The decision to get a finger joint replacement is largely down to the level of pain caused and how much this impacts on everyday life.
There are two types of operation which are helpful for arthritic fingers: Fusing the joint (arthrodesis) or joint replacement (arthroplasty). These are day case operations which can usually be done by ‘awake surgery’ using local anaesthetic. It could be that some patients will have more than one finger joint replacement in a single operation. A small incision is made in the finger, the damaged joint is removed and the artificial joint is inserted. The artificial joint is made of silicone plastic, metal or ceramic. It functions in the same way as a healthy joint, a bit like a hinge on a door, although the movement is typically about half the range in a healthy joint. Alternatively, fusing the joint means that it is set in a fixed position and no further movement is possible. Both types of operation reliably remove the pain from arthritis but of course have different results regarding the freedom of movement in the hand.
After surgery, some hand physiotherapy is necessary for several weeks and protective splints are often required during this period but typically these may be removed at times to do light activities as well as physiotherapy exercises. After about 8-10 weeks patients should be able to resume usual activities including golf, tennis and gardening, for example.
Mr Oliver Harley is a Consultant Plastic and Reconstructive Surgeon at Horder Healthcare in specialising in hand surgery. You can speak to your GP to arrange referral to Horder Healthcare for treatment as a NHS or private patient.