Joint Replacement Surgery of the Hand

  • Medical Author:

    Dr. Morris earned his bachelor's degree summa cum laude from the University of San Diego and received his Doctor of Medicine degree from UCLA School of Medicine in 1990. After medical school, Dr. Morris completed his surgical internship and orthopedic surgery residency training at the University of Southern California (LAC/USC Medical Center).

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Ultrasound Imaging of Joints in Rheumatoid Arthritis (RA)

A traditional method of monitoring the joint disease of patients with rheumatoid arthritis is X-rays, whereby images are produced by exposing photographic film (radiographs). This technique has proven useful for doctors to follow the course of joint destruction. The early development of discrete bony destruction (erosions) is associated with more severe rheumatoid disease. While standard X-ray radiographs contribute substantially to the clinical evaluation of rheumatoid arthritis, they do lack some sensitivity early in the course of disease. This means that substantial joint destruction must happen before changes on the standard X-ray test become apparent.

What happens in joint replacement surgery?

Joint replacement surgery involves replacing a destroyed joint with an artificial joint. In knee or hip replacement surgery, the artificial joint is made out of metal and plastic. In the case of joint replacement in the hand, the new joint is most commonly composed of silicone rubber or the patient's own tissues such as a portion of tendon.

Joint replacement surgery, also known as arthroplasty, is very common. Each year, orthopedic surgeons perform thousands of joint replacement surgeries in the U.S. (Most of these procedures are performed on the large weight-bearing joints such as the hips and knees.) Joint replacement surgery in the hand is typically used in treating severe arthritis that involves the small joints of the hand.

The hips and knees receive continuous stress from walking, running, sporting activity, or injury and are more commonly affected by the wearing of cartilage (degenerative arthritis) than the hand joints. However, the joints of the hand do experience stress in everyday use, and because the hand joints are smaller, these stresses are concentrated over a smaller surface area. The high ratio of stress to surface area can cause the smooth joint cartilage to wear over the years. As the cartilage degenerates, the underlying bone becomes exposed. When the deteriorated joint moves, bone rubs upon bone causing pain, swelling, limiting motion, and frequently causing a grinding or popping sensation. Furthermore, forms of arthritis that are caused by inflammation of the tissues lining the joint frequently affect the small joints of the hands and wrists to cause joint destruction. Examples include rheumatoid arthritis and psoriatic arthritis.

Medically Reviewed by a Doctor on 3/14/2016

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