Arthritis, or joint inflammation, occurs when the cartilage that normally covers the joint surfaces and allows them to glide smoothly “wears out.” Arthritis can occur in any joint in the body, but is very common in the hand and wrist and can bother you even during seemingly easy activities like writing or opening jars! Osteoarthritis, post-traumatic arthritis, and rheumatoid arthritis are the most common arthritic conditions in the hand.
One of the more involved treatments for arthritis is joint replacement. This involves removing the arthritic areas (or all) of the joint and replacing them with metal or plastic implants. The goals are to reduce the amount of pain, allow functional motion, improve the cosmetic appearance of deformed joints, and improve overall hand function. There are different options for the finger joints and the wrist joint, and each option has advantages and disadvantages.
As with any other surgery, there are risks of joint replacement surgery. Implants can loosen, break, wear out, or become infected, in which case you might need more surgery. There also are risks of infection, dislocation, stiffness, pain, and nerve or blood vessel damage.
Hand therapy usually is prescribed for months after joint replacement. Splinting and motion activities are used to make sure you get the best use out of your hand.
If you have an infection in the joint, problems with the quality of your skin or bone, problems with the muscles or tendons that usually move the joint, or other such issues, you might not be a candidate for a joint replacement. Other options include oral anti-inflammatories, steroid injections, hand therapy, splinting, and “arthrodesis” or fusion of the joint.