Osteoarthritis of the Hand
What is osteoarthritis of the hand?
Osteoarthritis – known as wear and tear arthritis – is a progressive, degenerative disease in which the surface layer of cartilage in the thumb or finger joint slowly wears away. Cartilage is a rubbery tissue that allows bones to glide smoothly over one another. Without the cushioning effect of cartilage, the bones of the joint rub together and the joint becomes stiff, swollen and painful.
Osteoarthritis of the hand most commonly affects the joint at the base of the thumb (the basal joint), the joint in the middle of the finger (proximal interphalangeal joint) and the joint closest to the fingernail (distal interphalangeal joint).
What causes osteoarthritis of the hand?
Risk factors for osteoarthritis include age, traumatic injury such as a broken finger, joint infections and overuse.
What are the symptoms?
Symptoms develop gradually and may include:
- Joint pain, swelling or stiffness
- Grating or grinding of the affected joint
- Loss of motion in the affected joint
- Pain or difficulty gripping or squeezing
- Joint weakness
- Tenderness and redness in the affected joint
How is the condition diagnosed?
In addition to a physical exam and patient history, your doctor may use specific tests, such as an X-ray, to diagnose hand arthritis.
What is the treatment?
There is no cure for arthritis, but treatment can help slow its progression, reduce pain and increase function. Conservative measures include rest, splinting, over-the-counter medications, corticosteroid injections and physical therapy.
If these non-operative treatments don't work, surgery may be necessary. The type of surgery performed depends on the finger joint involved.
Joint fusion (arthrodesis). Typically performed on the distal interphalangeal joint, the damaged bones of the joint are fused together, creating a stronger, more stable and essentially pain-free joint, but with limited flexibility or movement.
Joint replacement (arthroplasty). Typically performed on the proximal interphalangeal joint, this minimally invasive procedure relieves pain and restores shape and function in the hand. The surgeon makes a small incision on the finger's palm side, removes the damaged joint and cements a silicon implant in its place. The artificial joint functions similarly to a door hinge, but doesn't fully replicate normal finger motion.
Most patients begin rehabilitation with a Certified Hand Specialist within a few days of surgery. Patients wear a removable splint for several weeks to keep the joint stable and help the soft tissues heal. Overall recovery time varies by patient, but usually takes a few months.
Finger replacements are far less common than hip or knee replacements and the procedure is challenging due to the joint's intricate bone structure. It's important that you consult a hand and upper extremity specialist trained in this technique.