Joint Replacement Surgery of the Hand

Medical Author: John Morris, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

• What happens in joint replacement surgery?
• What are symptoms and signs of arthritis of the hand and wrist?
• How are patients with hand joint abnormalities evaluated?
• What are the different surgical options?
• When is surgical cleaning of the joint the best alternative?
• What is a joint fusion? When is it the best surgical option?
• When is joint replacement surgery the best surgical option?
• How do the surgical options vary with the different joints of the hands and wrists?
• Joint Replacement Surgery of the Hand At A Glance
• Find a local Orthopedic Surgeon in your town

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.