Finger Joint Replacement
in Rockhampton

What is going on

Finger joint arthritis affects two main joints — the middle (proximal interphalangeal, PIP) joint and the knuckle (metacarpophalangeal, MCP) joint. Patients describe pain, swelling, stiffness and a knobbly, sometimes crooked finger that catches when bending. Osteoarthritis is the commonest cause; rheumatoid and other inflammatory arthritis also destroy these joints and frequently affect several fingers together. The fingertip (distal interphalangeal, DIP) joint is commonly affected too, but is rarely replaced — it is small and pinch depends on its stability, so it is usually fused rather than replaced. Joint replacement is considered chiefly for the PIP and MCP joints, where keeping movement matters most.

Not sure if this is the right diagnosis? The hand pain hub triages the differential by anatomical location.

What the operation involves

A finger joint replacement removes the worn joint surfaces and inserts a small implant — a flexible silicone spacer or a two-part pyrocarbon resurfacing implant — through a short incision over the back of the joint. It is a day-case procedure under regional or general anaesthesia, taking around 45 to 60 minutes per joint, followed by a hand-therapy splint. The alternative, joint fusion (arthrodesis), removes the joint and fixes the bones together for a stable, pain-free but stiff finger. Full clinical detail is on the finger joint replacement education page, with the underlying arthritis covered on the PIP joint arthritis page.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the finger joint replacement education page or the hand surgery overview.

How this case is handled

Finger joint replacement is an uncommon, technically demanding operation, and the replacement-versus-fusion decision is made joint by joint with the specific finger and the patient's hand demands in mind. Hand therapy with Ruby Doolan at Extend Rehabilitation is built into the pathway from the first dressing change, because the early-motion programme largely determines the final movement. Where several finger joints are involved — as is common in rheumatoid arthritis — surgery is planned in stages and coordinated with the patient's rheumatologist.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 46309 Finger joint replacement (arthroplasty)

One joint

Item 46312 Finger joint replacement (arthroplasty)

Two joints

Item 46315 Finger joint replacement (arthroplasty)

Three joints

Item 46318 Finger joint replacement (arthroplasty)

Four joints

Item 46321 Finger joint replacement (arthroplasty)

Five joints

Item 46322 Revision finger joint replacement

One joint

Patient questions we hear most

• Can a finger joint really be replaced?

  Yes. The middle (PIP) joint and the knuckle (MCP) joint can be replaced with a small silicone or pyrocarbon implant that relieves pain while preserving movement. The fingertip (DIP) joint is the exception — it is small and pinch relies on its stability, so it is almost always fused rather than replaced. A finger replacement is a smaller operation than a hip or knee replacement, but the principle is the same: the worn joint surfaces are removed and an implant takes their place.

• Should I have the joint replaced or fused?

  Both relieve the pain reliably; the difference is movement versus stability. Replacement keeps the finger bending, which matters most for the ring and little fingers and for the knuckle joints, and for tasks like making a fist or gripping a rail. Fusion gives a stable, strong, pain-free but stiff joint, and is preferred for the index finger PIP joint and for high-load joints where pinch strength matters more than movement. The decision is made joint by joint at the consult, taking account of which finger, the bone quality on X-ray, and how the hand is used.

• How long does a finger replacement last?

  Silicone implants have been used for finger joints for decades and have a long track record; they can fracture or wear over many years, but are straightforward to revise. Pyrocarbon resurfacing implants aim to preserve more natural movement and bone, with good medium-term results reported. As with any implant, heavy manual loading shortens its life, which is part of why the replacement-versus-fusion choice is weighed against how the hand is used. Longevity and the small chance of needing a revision are discussed individually before surgery.

• Will my finger bend normally after a replacement?

  The aim is a comfortable finger with useful, not perfect, movement — typically a functional arc that lets you grip and make a fist, rather than the full range of a normal joint. How much movement returns depends heavily on the early hand-therapy programme, the starting stiffness and deformity, and the joint involved. The trade-off is favourable compared with fusion, which gives a permanently stiff (though stable and pain-free) joint. Realistic expectations for the specific finger are set out at the consult.

• How much does finger joint replacement cost? What does Medicare cover?

  The operation is performed under regional or general anaesthesia at Mater Private Hospital Rockhampton, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — the Medicare item, the rebate and the out-of-pocket gap each shown separately. Implants are typically covered by private health funds; patients without private cover can be quoted self-funded. Surgery does not proceed without itemised written informed financial consent — the fees page explains the full process.

More general questions about appointments, fees and the practice on the FAQ page.