Finger Joint Arthritis and Joint Replacement Arthroplasty

January 29, 2025

Arthroplasty or reconstruction of a damaged joint is common understanding for treating the hip, knee and shoulder. Most patients are unaware of treatment options for the small joints of the fingers. Frequently, the small joints of the finger can also be replaced with an artificial joint.

Since the mid 20th century, total joint replacement (TJR) of the small joints of the fingers provided pain relief for many patients with inflammatory arthritis. As time has passed, the indications for TJR of the fingers has expanded to include inflammatory arthritis, osteoarthritis and post-traumatic arthritis. As the implants have evolved and surgical technique improved, the age to consider TJR migrated into earlier ages.

Most patients suffering from problems can be categorized into either a painful joint, a deformed joint, or an unstable joint. Each category represents unique surgical considerations, yet all or a combination of these categories are considered appropriate indications for TJR of the fingers.

Early in the development of TJR using an implant, the goal of surgery was to preserve “some” motion but eliminate painful contact between both sides of the arthritic joint. The implant for arthroplasty (TJR) was considered a functional spacer or a prosthetic that separated the painful bone contact and provided limited range of motion.

The design of Implants developed in the last 30 years is to prevent painful arthritic bone contact yet preserve soft tissue structures to simultaneous reduce or eliminate pain and provide a foundation for preserving or restoring full range of motion. This implant design is termed surface replacement arthroplasty or SR arthroplasty. The SR implants are semi-constrained, meaning preservation of bone, ligaments and tendon insertions are optimal to implant function.

SR arthroplasty or TJR requires master knowledge of anatomy and meticulous surgical technique and attention to detail. The type of arthroplasty is not readily available to many “hand surgeons” and thus, is not offered to many patients.

Illustration of Surface Replacement Arthroplasty for the proximal Interphalangeal joint (PIP) Cobalt Chrome with Polyethylene insert. This implant is intended to be inserted with bone cement.