Finger joint arthritis presents with generalised discomfort in the ﬁnger movements. It may be associated with swelling around the ﬁnger joints and there may be some deformity.
As arthritic changes develop in the joints, patients will often experience bone growth or spur formation and this can result in deformity around the joint. The joints are often enlarged and it may be difﬁcult to fit rings on ﬁngers etc.
Treatment options depend on which joints are involved and the severity of the pain.
Initial treatment usually involves simple anti-inﬂammatory medications to try and settle the swelling around the joints and control the pain.
If patients reach the point where they are unable to function well with their arthritic pain, they may decide to consider surgical solutions.
The distal joints (the joints closest to the fingernails) in the ﬁngers are commonly affected. These joints often have some angular deformity. If patients present with painful stiff joints, a fusion may remove the pain associated with the arthritis.
In the more proximal joints (the joints in the middle of the fingers) the aim is to try to preserve range of movement as much as possible. Steroid injections may give some temporary relief in acutely inﬂamed joints but doesn't change the underlying degenerative nature.
Replacement of the metacarpophalangeal joints and the proximal interphalangeal joints is possible. This involves resecting the arthritic joint surfaces and replacing them with either metallic or silastic (silicon rubber) replacement components.
The aim is to resurface the joint and provide a smooth and comfortable range of movement. This is an effective way of improving discomfort within the ﬁngers. Patients may still have some stiffness within the joints but usually function improves considerably after surgery.
Post surgical care
Hand therapy is important after joint replacement surgery to try and regain the range of movement of the joints.
Risks of surgery
Every operation has some element of risk associated with it. There is always the potential for infection when the skin is opened. There is also potential for some stiffness within the joint following joint replacement surgery.
The joint replacements themselves can wear out over time and in some cases the prosthesis may become loose. This may necessitate revision in future years.
Patients with rheumatoid disease may often have soft tissue issues, which may necessitate relocating or transferring tendons to provide stability to the joints.