Arthritis and joint replacement

Arthritis and joint replacement

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.

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.

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 re-positioned 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, wearing off 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.

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