Metacarpo-phalangeal (MCP) Joint Replacement

When to consider a MCP joint replacement?

When non-operative treatments have failed to control the pain and the pain is:

• Moderate to severe
• Constant/ all the time
• Affecting sleep
• Stopping you from carrying out activities of daily living

What to expect after an MCP joint replacement.

After having the operation you will be sent home in a cast for comfort and to protect the joint.

Within 1-2 weeks you will be seen by a member of the Hand Therapy Team and the dressings will be removed and a splint will be made to protect the joint replacement. Stitches will be removed at 10-12 days after your operation.

You will normally be advised by the Hand Therapist at this stage on some exercises to move your finger safely – it is important that early movement is achieved to prevent stiffness at the joint.

You can expect to be in a splint for up to 6 weeks after the operation. You may still need to wear some form of splint/ support for up to 12 weeks.

You will not be able to do any ‘heavy lifting/ strenuous activity’ for around 8-10 weeks after your operation.

You will require regular appointments with the Hand Therapist to ensure you regain function in your finger.

Things to consider before having a MCP joint replacement:

• Risk of infection in joint replacement is a serious complication. Precautions are taken to avoid this including intravenous antibiotics during the operation (antibiotics given directly into the blood stream). Infection may respond to antibiotics but if serious may require further surgery.
• Infection can put the joint replacement at risk.
• Risk of stiffness following the operation. Surgery is aimed at reducing pain. Movement may improve but this is not guaranteed. Some stiffness may remain as a result of scarring, the arthritis and the surgery.
• Risk of problematic scar tissue. After the operation there is a risk that you may have problems with scarring including tender/ sensitive scarring. Thick/ hard scarring causing reduced movement.
• The joint replacement may wear out or loosed over a period of 5-10 years and result in recurring pain.
• Risk of Reflex Sympathetic Disorder (RSD). Can also be known as Chronic Regional Pain Syndrome (a malfunction of the nervous system that controls your pain).