Joint Surgery for Hand & Wrist Arthritis Differs by Location

Every joint serves a different function and performs different task. For this reason, the best hand joint replacement surgery options differ according to the specific joint that is involved.

In this article we discuss some of the generally situations in which one joint surgery is usually better than another type of joint surgery for a specific joint. However, your case may differ. To understand which hand surgery is best for you, schedule a consultation and diagnosis with board certified hand surgeon Dr. Rehman.

When Do You Need Joint Surgery for Arthritis?

Surgery for hand and wrist arthritis becomes a consideration when conservative treatments no longer provide adequate pain relief or functional improvement. Most patients with early to moderate arthritis respond well to non-surgical approaches including anti-inflammatory medications, activity modifications, splinting, corticosteroid injections, and specialized hand therapy. However, when these interventions fail to manage symptoms effectively and daily activities become significantly impaired despite consistent conservative care, surgical options warrant discussion.

The progression to surgery typically occurs when patients experience persistent pain that interferes with sleep, inability to perform necessary work or personal tasks, or progressive deformity that compromises hand function or appearance. The timing of surgical intervention varies considerably between individuals and depends on several factors beyond just the radiographic severity of arthritis.

Certain clinical signs may indicate that the appropriate time for surgical intervention has arrived. These include joint instability that causes the fingers to shift out of proper alignment during use, progressive deformity that interferes with adjacent digit function, significant motion loss that impairs essential activities, or relentless pain that remains unresponsive to appropriate conservative measures.

Dr. Rehman emphasizes that modern surgical approaches aim to preserve as much natural joint function as possible while addressing pain and deformity, particularly in younger patients. However, when arthritis has advanced to complete cartilage destruction with bone-on-bone contact, earlier surgical intervention may provide better quality of life compared to prolonged conservative management with inadequate symptom control.

Dr. Uzma Rehman, one of the best Bloomfield Hills area hand surgeons, evaluates each patient’s unique circumstances including their pain tolerance, functional requirements, occupational demands, and personal goals when considering surgical recommendations.

Best Surgery for Joint Closest To the Fingertip (DIP)

The best treatment option for advanced arthritis for joint closest to the fingertip (DIP joint) is generally joint fusion. This is because pain is relieved, while functioning of the hand is only minimally affected by lack of motion at this joint after fusion.

However, the DIP joint is typically not a good location for joint replacement, because the bones involved are very small and do not hold a joint implant very well.

Best Surgery for Second Joint from the Fingertip (PIP)

Joint replacement is commonly considered a good treatment for arthritis in the second joint from the fingertip – also known as the PIP joint.

The small or “baby” finger and the ring finger are typically considered to be the best candidates for joint replacement – since they are most needed for powerful grasping.

However, joint replacement is not typically recommended for the index finger PIP joint, because it must withstand strong sideways force when turning, opening or manipulating of objects – like turning a key or opening a jar. This forces can cause too much stress on the artificial joint, leading it break.

Joint fusion is generally not recommended often for second joint from the fingertip, because hand function, especially grasping, can be hindered by joint fusion.

The best candidates for PIP joint replacement are patients with rheumatoid arthritis, as well as older, lower-activity patients who will not put undue stress on the artificial finger joint(s).

Best Surgery for Third Joint from the Fingertip (MCP)

The third joint from the fingertip – or MCP joint – is generally an excellent location for joint replacement surgery.

The most common candidates for MCP joint replacement are patients suffering from joint destruction due to rheumatoid arthritis. However, osteoarthritis rarely affects the third joint from the fingertip.

Silicone joint replacement of the third joint from the fingertip has been in practice since the 1960s, and offers highly effective long-term results.

Best Surgery for Thumb Basal Joint

The thumb basal joint is where your thumb connects to your wrist. This joint undergoes a great deal of very high stress and impact with even normal daily activities. This predisposes the thumb basal joint to a great deal of wear and tear. As a result, arthritis of the basal thumb joint is very common, especially in women.

Joint replacement is frequently performed on this joint in order to eliminate pain while restoring mobility to this important joint. However, artificial silicone joint replacements are typically not successful in this location, due to implant failure from the high amount of stress on the joint.

Generally, the most highly recommended joint replacement surgery for the thumb basal joint is performed using natural material. This procedure is called “ligament reconstruction-tendon interposition” – or LRTI. It is also sometimes called a tendon roll or “anchovy procedure”.

During LRTI surgery, the patient’s own tendon is used to stabilize the thumb as well as to resurface the joint. Long-term results are typically excellent, providing joint stability as well as pain relief.

Best Surgery for Wrist Joint

Generally, the best treatments for patients with wrist arthritis are surgical joint cleaning, or fusion.

Joint replacement is typically not recommended for wrist joint arthritis. This is because artificial joints often cannot withstand the amount of very strong impact and repetitive motions demanded of the wrist.

At this point, the artificial wrist-joints on the market are still experimental – and only being used in extremely low activity patients with rheumatoid or osteoarthritis arthritis.

How to Choose the Best Surgeon for Joint Surgery

Selecting the best surgeon for hand or wrist joint surgery significantly influences both the technical outcome and overall surgical experience. Board certification in hand surgery ensures that your surgeon has specialized training and demonstrated expertise specifically in hand and upper extremity procedures beyond general orthopedic or plastic surgery training.

Beyond technical qualifications, effective communication and a compatible approach to shared decision-making prove equally important when selecting your hand surgeon. The best surgical choice for hand arthritis depends not just on the joint involved but on understanding each patient’s unique functional needs, aesthetic concerns, and recovery capacity. During your consultation with Dr. Uzma Rehman, renowned Bloomfield Hills area hand surgeon, she will explain all available options—both surgical and non-surgical—with their respective advantages and limitations. By presenting multiple approaches rather than recommending identical procedures for all patients demonstrates her thoughtful, individualized approach that is essential for the best joint surgery outcomes.

Patients should feel completely comfortable asking about a surgeon’s specific experience with their condition, typical outcomes including recovery timelines, and potential complications. Best Bloomfield Hills joint surgeon Dr. Rehman welcomes these questions and provides transparent, realistic expectations rather than overpromising results.

Top Joint Surgery Bloomfield Hills

The hand, finger and wrist joints are very complex – and an experienced hand surgeon can offer you many nonsurgical and surgical treatment options. Deciding which joint surgery alternative is best for you will depend on many factors, including the amount of pain, the degree of arthritis, your age, your lifestyle, and which joint(s) are affected by your arthritis.

Board certified Bloomfield Hills joint surgeon Dr. Rehman will carefully assess your condition, listen to your concerns, answer your questions, and help you determine which joint treatment or surgery is right for you.

Joint Surgery Bloomfield Hills: 248.940.5233