Name of the Procedure:

Arthroplasty, metacarpophalangeal joint; each joint (Common names: MCP joint replacement, Knuckle replacement surgery)

Summary

Arthroplasty of the metacarpophalangeal (MCP) joint involves replacing the damaged or arthritic joint in the hand with an artificial implant to restore function and alleviate pain.

Purpose

Arthroplasty of the MCP joint is performed to treat severe arthritis, joint deformities, or significant trauma that affects the hand's knuckles. The goal is to reduce pain, improve joint function, and increase the range of motion.

Indications

• Severe arthritis (e.g., osteoarthritis, rheumatoid arthritis)
• Traumatic injury or joint damage
• Chronic pain unresponsive to conservative treatments
• Joint deformity affecting hand function
• Stiffness or limited range of motion

Preparation

• Preoperative consultation with your surgeon
• Diagnostic imaging (e.g., X-rays, MRI)
• Blood tests and physical examination
• Fasting before surgery (specific instructions will be provided)
• Adjustments to medications, particularly blood thinners

Procedure Description

1. Anesthesia: General anesthesia or regional anesthesia is administered.
2. Incision: A small incision is made over the MCP joint.
3. Joint Exposure: The surgeon carefully exposes the joint by retracting the soft tissues.
4. Removal of Damaged Tissue: The damaged joint surfaces and any bone spurs are removed.
5. Implant Insertion: An artificial implant made of metal, plastic, or silicone is fitted into the joint space.
6. Closure: Soft tissues are repositioned, and the incision is closed with sutures or staples.
7. Dressing: A sterile dressing is applied to the surgical site.

Duration

The procedure typically takes about 1-2 hours per joint.

Setting

The procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic or hand surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection
• Bleeding
• Joint stiffness or loss of motion
• Implant loosening or failure
• Nerve or blood vessel damage
• Allergic reaction to anesthesia

Benefits

• Reduced pain and discomfort
• Improved joint function and hand mobility
• Enhanced quality of life and ability to perform daily activities

Recovery

• Postoperative pain management with medications
• Immobilization with a splint or cast initially
• Physical therapy to improve strength and range of motion
• Follow-up appointments to monitor healing
• Full recovery typically takes several weeks to a few months

Alternatives

• Non-surgical treatments (e.g., medications, physical therapy, splinting)
• Corticosteroid injections
• Arthrodesis (joint fusion) – sacrifices joint mobility for pain relief
• Pros and cons should be discussed with your healthcare provider

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Afterward, there may be some pain and swelling, which will be managed with medications. Physical therapy will be an essential part of the recovery process to regain full function and mobility of the hand.