PIP Joint Replacement Info Consent

Q: 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.

Q: 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.

Q: 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.

Q: 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.

Q: 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.

Why this operation has been suggested

This page reflects how Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic. We recommend proximal interphalangeal joint replacement when wear-and-tear arthritis causes pain and stiffness that limits your hand use. You usually reach our clinic by GP or physiotherapist referral. A clinic assessment establishes the diagnosis. For long-standing problems we try non-operative care first. We consider surgery when that has not given enough improvement.

This procedure replaces the damaged joint surfaces with an implant to restore motion and stability. It is typically offered for degenerative or post-traumatic arthritis. We perform this as an open operation through a single conventional incision. The main benefit is reliable pain relief and improved function. About 1 in 5 replacements with a pyrocarbon implant may need revision surgery by 5 years. Approximately 1 in 3 may undergo more than one operation. We discuss these figures with you to support a shared decision.

Before the operation

You will need blood tests and an anaesthetic review to ensure you are fit for surgery. Your surgeon may also order X-rays or an MRI to map the joint. You must fast before your procedure and stop certain medications as directed. Please bring a full list of your current medicines. Wear comfortable, loose clothing on the day. Because you will have a single incision over the joint, you need someone to drive you home. You cannot drive yourself after the anaesthetic. Your surgeon will give you specific instructions on which medicines to pause and when to stop eating or drinking.

On the day

This operation is done under general anaesthetic. You will be fully asleep for the operation. Some patients may also have a regional nerve block for post-operative pain relief — the anaesthetist decides on the day based on your individual circumstances.

You will arrive at the hospital and meet your surgeon before going to the operating theatre. We use an open approach with a single conventional incision over the operative site. This allows us to access the joint directly. After the procedure, you will wake up in recovery. Our team will monitor you closely as the anaesthetic wears off. You can expect some soreness, which we manage with pain relief. Most patients return to work after a median of 8 weeks. We will guide you through your initial recovery steps before you go home.

What the operation involves

Your surgeon makes a single cut over the front or side of your finger joint. This open approach gives clear access to the area that needs treatment. The surgeon carefully moves aside the soft tissues to reach the joint surfaces.

Inside, the worn-out ends of the bones are removed. Your surgeon then places a new implant to replace these surfaces. This implant helps restore motion and stability to your finger. In some cases, your surgeon may also adjust the tendons or ligaments around the joint to improve balance and movement.

Once the new parts are in place, your surgeon closes the cut with stitches or staples. A dressing is applied to protect the area as it begins to heal. This procedure is designed to relieve pain and improve how your finger moves.

After the operation

You will wake up in the recovery ward with your hand in a protective dressing and splint. Most patients stay one night in hospital after this operation, though some are able to go home the same day. Your surgeon will manage your pain using standard methods to keep you comfortable. You must have someone stay with you for the first 24 hours to help you at home. We use a single conventional incision over the operative site for this open approach. Keep the dressing clean and dry while it heals. You cannot drive while wearing the finger splint because it prevents a safe grip on the wheel. Please see Driving after upper-limb surgery for more details on when you can resume driving once the splint comes off and your surgeon clears you.

Recovery

You will notice swelling and stiffness in your hand after surgery. This is normal. Your surgeon will guide you on managing discomfort. Most patients find that pain eases as swelling settles over the first few weeks. If you had pre-existing tenderness, you may feel minor ache for up to 3 months. This is expected.

We use a single conventional incision over the joint. You will wear a splint to protect the area. Do not drive while the splint is on if it prevents a safe grip on the wheel. Once the splint comes off and your surgeon clears you, you can resume driving. See our guide on Driving after upper-limb surgery for more details.

Hand therapy is essential for your recovery. We work with Ruby Doolan at Extend Rehabilitation to guide your exercises. You will start gentle movements early to keep the joint flexible. Your therapist will help you progress safely. You will learn how to use your hand for daily tasks without straining the repair.

Recovery varies between individuals. Your timeline may differ from others. Your surgeon and physio will guide you based on how your hand responds. We focus on restoring motion and strength so you can return to your routine. Trust the process and follow your team’s advice closely.

What can go wrong

Most patients do well, but problems can occasionally happen. Your surgeon and the team monitor you closely to spot any issue early.

Infection Infection around the implant is uncommon. However, you might notice redness spreading from the wound, increased warmth, or pus draining from the incision. You may also feel a deep, throbbing pain that does not ease with simple painkillers. If you see these signs, call the clinic immediately. Do not wait for your next scheduled review.

Tendon or Extensor Mechanism Issues The extensor mechanism refers to the tendons and tissues on the back of your finger that help you straighten it. Dysfunction here is a frequent reason for needing another operation. You might feel a sudden weakness when trying to straighten your finger. You could also notice a clicking, grinding, or catching sensation as you move the joint. If you lose the ability to straighten your finger fully, contact us right away.

Need for Further Surgery Some patients require additional procedures. This might involve adjusting the implant or replacing it entirely. You might notice that your finger is not moving as smoothly as expected, or that pain returns after initially improving. If you feel your recovery has stalled or worsened, bring it up at your next appointment. We can assess whether further intervention is needed.

General Recovery Notes Returning to work typically takes about 8 weeks. If you are working with your hands, you might feel stiffness or fatigue during this period. This is normal. However, if you experience severe pain or sudden swelling, do not push through it. Rest the hand and seek medical advice.

The complications table on this page lists typical rates if you want the specifics.

When to call us

Call us if you have a fever, increasing wound redness or discharge, or sudden severe pain. Go to emergency if you notice calf swelling or shortness of breath. Contact us immediately for loss of sensation or inability to move your hand. These symptoms need urgent assessment to ensure your recovery stays on track.