Cambridge Plastic Surgery

Plastic and reconstructive surgery, hand surgery and aesthetic surgery


Finger joint replacement

Prosthetic joint replacement surgery can be considered for a painful and stiff finger joint. This is an operation most commonly performed for advanced osteoarthritis.

Finger joint replacement requires careful planning and exacting post operative hand therapy. It is not suitable for patients who cannot attend hand-therapy appointments regularly for at least six weeks after surgery. The operation is under general anaesthetic as a day case procedure.

I have used the Ascension Pyrocarbon proximal inter-phalangeal joint replacement, and metacarpo-phalangeal joint replacement, for ten years. Pyrocarbon, is a strong ceramic like material with similar mechanical properties to bone. Joint replacement requires removal of the existing joint surfaces with a very specific geometry that allows the two parts of the pyrocarbon prosthetic joint replacement to be inserted with a tight fit: no cement or screws are used to hold the prosthesis in position.

Further information
Patients can find further information on the Ascension website:
www.integralife.com/index.aspx?...PyroCarbon%20PIP%20Total%20Joint...

Results

The operation is reliable at reducing pain, the range of movement after surgery is less predictable: on average patients will achieve 10 degrees improvement in their active range of movement, some patients achieve more, others less. Most patients have an improvement in their pinch and power-grip strength.

To provide access to the joint surfaces the extensor tendons are split, patients almost invariably need to wear a protective splint in between exercises for about 4-6 weeks after surgery to allow this split to heal fully. A significant proportion of patients will also hear a relatively quiet squeak after finger joint replacement surgery when they bend their finger.

Risks

All joint replacements can loosen or become displaced with time. Data looking at the survival of pyrocarbon metacarpophalangeal joint replacmenst suggest that at 15 years after surgery approximately 30 % of the replacement joints will have become loose.

To make an appointment
please call 01223 550 881 or email: igrant@uk-consultants.co.uk

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