Joint Replacement in Hands, Wrists and Elbows
What is joint replacement?
Joint replacement is a procedure that involves replacing a joint with an artificial joint made of a metal such as titanium in the wrist and elbow or the fingers using silicone or a metallic pyrocarbon implant, or removing the joint and replacing with a tendon from your own body such as with basilar thumb arthritis.
When is a joint replacement performed?
Any condition that can lead to joint destruction such as common degenerative joint disease or osteoarthritis or less common trauma, rheumatoid arthritis, etc. will ultimately lead to pain, stiffness and deformity. The track record for small joint replacement is not nearly as beneficial long term as with larger joint replacements in the hip and knee due to loosening or breakage. Nevertheless in a patient with severe arthritis at certain joints such as the MCP and PIP joint of the fingers of the hand and patients with involvement of both wrists a joint replacement is usually preferred over a joint fusion or arthrodesis. In many cases a joint replacement if it fails can be converted into a fusion as a last resort. In single wrist arthritis usually from trauma a partial arthrodesis fusing only part of the bones preserves part of the wrist movement in favor over a total arthrodesis of the wrist which is uncommon. In the elbow neither a replacement or joint arthrodesis should be performed if possible as the replacement usually doesn’t hold up to the demands of an active individual and an arthrodesis significantly limits function. Elbow arthrscopy may buy some time in making this decision.
Who should perform a joint replacement?
Joint replacements should be performed by surgeons with knowledge of not only performing the surgery but when to perform such an aggressive reconstructive hand procedure. Dr. Knights knowledge of reconstructive hand surgery, allows him to first make sure all conservative treatment has been exhausted and then carefully assess your needs in activities of daily living, work, hobbies and sports to come up with a solution that is right for you.
MCP joint replacement of all finger on the left hand of a patient with rheumatoid arthritis compared to right side prior to replacement.
“Due to arthritis, I found myself in the position of requiring an artificial joint replacement in my index finger. While the surgery appeared to go well, my finger eventually became stiff and unusable. My original surgeon had moved and other doctors I consulted wanted to fuse the finger. This was unacceptable so I did my research into hand surgeons and determined Dr Knight was my best hope.
During my first visit to Dr Knight, I was impressed with his knowledge and his optimism. He felt strongly that he could help me regain the use of my finger and we set up the surgery. The surgery was a complete success and his skill was readily apparent. I had very little swelling, little pain and the surgery scar was almost non-existent. I now have almost full range of movement in my finger. I could not be more pleased with my experience with Dr. Knight and his staff. Dr. Knight is a very skilled surgeon and I would recommend him to anyone requiring treatment of the hand or wrist.”
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