The two main surgical options for hand arthritis are fusion (arthrodesis) and total joint replacement (arthroplasty).
In arthrodesis, the bones of the joint are fused together, creating a stronger, more stable and essentially pain-free knuckle, but one with little flexibility or movement.
Arthroplasty involves removing the damaged joint and replacing it with an artificial implant. The goal is to relieve pain and restore shape and some function in the hand, but the results are usually less satisfactory than with hip and knee replacements
Base of the fingers:
Proximal interphalangeal joints are the second from the base of the hand. They’re prone to stiffness and a significant loss of motion, usually as a result of osteoarthritis. Replacement surgery is sometimes used to relieve these symptoms, especially in the middle and ring fingers, which need to remain flexible for griping. But these joints get heavy use, so implants can wear out quickly.
Ends of fingers:
Arthrodesis is commonly used to treat arthritis pain in the distal interphalangeal joint. It usually results in a stable, pain-free and reasonably functional joint. The most serious complication is failure of the fused bones to grow together or properly align, which may require further surgery. Most people have good to excellent results. Motion is one of the biggest failings of finger surgery. Not only does it not improve after treatment, it’s often reduced further in the pursuit of pain relief.