Joint Replacement Surgery in the Hands

I have had rheumatoid arthritis since 1982 and as a result, have suffered some degenerative damage to the joints in my hand. Fortunately, modern medicine has developed some wonderful treatments for such problems. In February, 2001, I had MCP arthroplasty in my right hand. Essentially, the MCP joints (knuckles) of my right hand were replaced with silicone, which stabilized and straightened my hand back to a more normal shape. Here's what the end result looks like.

right hand - back		right hand - front

In April, 2002, I had my left hand done as well. Below are pictures of the previous, messed-up state of my left hand. Ugly, ain't it? It looked a lot worse than it felt, but the joints were steadily becoming more and more damaged. The right hand looked much the same before the surgery, though I don't have any good "before" photos of that hand.

left hand - back		left hand - front

Here is what the left hand looks like six weeks after surgery.

left hand - back		left hand - front

After surgery, I was in a half-cast for aproximately four weeks. Once the cast was off, I had to wear some splints to keep the joints in alignment. The "active" splint, called an "outrigger" by my occupational therapist, looks like a torture device, but is really quite comfortable. Some pictures of this are below.

outrigger splint - side view

The elastics are attached to leather slings, which keep the fingers in alignment while allowing for movement and exercise. Here is a top view of the splint.

outrigger splint - top view

Below is a closeup, frontal view of the outrigger splint.

outrigger splint - front view

While the outrigger splint was for daytime use, I also had a molded plastic "resting" splint for night time (so as not to sleep with the fingers in an incorrect position). I also used this while driving, since the outrigger is a bit clumsy for traveling. Below are some pictures of that splint.

resting splint - side view

resting splint - top view

Overall, I have been quite pleased with both of my surgeries. The pain from this surgery is not bad at all. I found it to be less intense than a bad arthritis flare, and the doctors are quite willing to prescribe whatever pain drugs are necessary. After the first few days, I found I only needed my pain pills at night, with ibuprofen being plenty for any twinges I had during the day. Recovery time lasts about three months, with weekly visits for physical therapy as the hand gains flexibility and strength. While my hands are not as perfect as normal hands, they are very close and are much, much better that the crooked hands I had before. I can type better than I could before and can still do close, detailed work, like typing, hand sewing, and heavier physical activities like bicycling. My dexterity has improved, and I highly recommend this surgery to anyone with similar rheumatoid hand deformities.