Joint Replacement Surgery Of The Hand
The two main surgical options for hand arthritis are fusion (arthrodesis) and total knuckle replacement (arthroplasty). In arthrodesis, the bones of the joint are fused together, creating a stronger, more stable and essentially pain-free knuckle, but one with little flexibility or movement.
This surgical option is reserved for patients with advanced arthritis or with a hand deformity.
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 and most of this procedure is 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.
