If you’re struggling with arthritis in your hands, you’re probably familiar with the pain, stiffness, and limited mobility that make everyday tasks a challenge. While non-surgical treatments such as medication and physical therapy can provide relief, there may come a point when hand surgery becomes a more viable solution for you. But how successful is hand surgery for arthritis, and is it right for you?

At The Nerve Surgery Centre, we understand how debilitating arthritis can be. Founded by Mr. Tomas Madura, our centre provides exceptional quality healthcare for anyone suffering from pain and paralysis associated with a peripheral nerve problem in the hand or elsewhere in the body. Whether you’re looking for carpal tunnel surgery in Birmingham or a surgical solution to arthritis in your fingers, we want to help keep you informed about what treatment options are available and how they work. Be sure to have a look at our articles on similar topics, which answer common questions like, “Where is carpal tunnel surgery performed?

But for now, let’s explore the success of hand surgery for arthritis, what to expect from the procedure, and why you might want to consider it. 

What is Hand Arthritis?

How Successful Is Hand Surgery for Arthritis

Arthritis in the hands can be caused by several types of arthritis, but the most common forms are osteoarthritis and rheumatoid arthritis. Both of these conditions can lead to pain, swelling, and deformities in the joints, making it difficult to perform even simple tasks like gripping a cup or opening a bottle.

Types of Arthritis Affecting the Hand

Osteoarthritis

Osteoarthritis is the most common form of arthritis and is often referred to as “wear-and-tear” arthritis. This condition occurs when the cartilage between your joints gradually breaks down over time, leading to pain, stiffness, and decreased mobility. Osteoarthritis is typically related to ageing or repetitive stress on the joints.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disorder where your immune system mistakenly attacks the lining of your joints. This results in chronic inflammation, which can lead to joint damage over time. The condition can affect multiple joints, often starting in the smaller joints of the hands and wrists, and is typically more aggressive than osteoarthritis.

Post-Traumatic Arthritis

Post-traumatic arthritis can develop after an injury to the hand, even if the injury occurred years before. It can cause long-term pain and joint problems similar to osteoarthritis. The trauma to the joint can lead to cartilage deterioration, resulting in symptoms like pain, swelling, and stiffness.

Symptoms of Hand Arthritis

Arthritis in the hands has a few noticeable symptoms that may, as the condition worsens, limit your everyday activities. These include:

  • Joint Pain – Aches and discomfort that may worsen with activity or as the day goes on.
  • Swelling and Stiffness – You may notice swelling around the joints or stiffness that makes movement difficult.
  • Decreased Range of Motion – As arthritis progresses, your ability to move your hand and fingers freely may diminish.
  • Deformities – In more severe cases, arthritis can cause noticeable deformities in the fingers or hand joints.

These symptoms can be caused by other health conditions, so if you think that you might have arthritis, it’s recommended to contact your GP for more information.

What Are the Non-Surgical Treatment Options?

How Successful Is Hand Surgery for Arthritis

Before considering surgery, most doctors will recommend trying non-surgical treatments to manage arthritis symptoms. These are less invasive than surgery would be and focus on pain management and long-term strengthening exercises.

Common Treatments for Managing Arthritis Symptoms

One of the most common ways to manage arthritis symptoms is through pain relief medication. Over-the-counter options like ibuprofen, or stronger medications prescribed by your doctor, can help reduce both pain and inflammation.

Physical therapy is another important treatment, focusing on exercises that strengthen the muscles around your joints and improve flexibility. This can help you move more comfortably and reduce stiffness.

For added support, splinting or bracing can be helpful. Wearing a splint supports the affected joint, reduces strain, and eases pain, especially during everyday tasks.

Steroid injections are sometimes used when other treatments aren’t enough. These injections can offer temporary relief from inflammation and pain, giving you more comfort and freedom of movement for a period of time.

When Should You Consider Surgery?

You might want to consider surgery if your pain persists despite trying these treatments, or if arthritis has severely impacted your hand function. When your ability to perform daily tasks is compromised, and non-surgical options no longer provide relief, surgery may offer a more permanent solution.

What Types of Hand Surgery Are Available for Arthritis?

How Successful Is Hand Surgery for Arthritis

Several surgical options are available depending on the severity of your arthritis and the specific joints affected.

Joint Fusion (Arthrodesis)

  • Joint fusion, also known as arthrodesis, is a surgical procedure where the bones in a joint are permanently fused together, creating one solid bone. This procedure is commonly recommended for patients with severe arthritis in the smaller joints of the hand, especially when other treatments have not provided sufficient relief. The goal of this surgery is to reduce pain and improve hand function by stabilising the affected joint. Although the movement in the affected joint is lost, there is no pain associated with using the hand and that in turn increases the hand functionality.
Benefits Limitations
Significant pain relief: By fusing the bones, joint movement is eliminated, which stops the bones from rubbing together and causing pain. Loss of mobility: Once the joint is fused, it will no longer bend or move, which can limit certain hand movements.
Improved stability: The fused joint becomes more stable, which can be beneficial for people who rely on hand strength for tasks. Altered hand function: While pain is reduced, the loss of flexibility in the affected joint may impact fine motor skills or tasks requiring dexterity.
Durable, long-term solution: Joint fusion is a permanent procedure that typically provides long-lasting pain relief. Risk of stress on adjacent joints: The lack of mobility in the fused joint can cause additional strain on nearby joints, potentially leading to future problems.
Reduced inflammation: Fusion can reduce chronic inflammation in the joint, further improving comfort and quality of life. Recovery time: The healing process can be lengthy, requiring weeks to months of recovery and rehabilitation.

 

This procedure is ideal for those who prioritise pain relief over maintaining joint flexibility, especially in cases of advanced arthritis where preserving joint motion is no longer feasible.

Joint Replacement (Arthroplasty)

How Successful Is Hand Surgery for Arthritis

Joint replacement, or arthroplasty, involves removing the damaged or arthritic joint and replacing it with an artificial implant, which can be made from materials such as silicone or metal. This procedure is typically recommended for larger joints in the hand, such as the wrist, base of thumb or knuckles, where maintaining motion is important for everyday activities.

Benefits Limitations
Pain relief: Replacing the damaged joint eliminates the painful friction caused by arthritis, providing significant relief. Limited strength: The artificial joint may not be as strong as a natural joint, and you may have limitations on how much force you can apply when using it.
Restored joint movement: Unlike joint fusion, this procedure preserves joint movement, allowing you to maintain flexibility and a range of motion. Potential wear and tear: Over time, the artificial joint may wear out, especially in more active individuals, and could require revision surgery.
Improved function: The surgery can help you regain the ability to perform tasks that require dexterity, such as gripping, holding, or writing. Longevity of the implant: Artificial joints typically last for many years but may eventually need to be replaced, especially in younger or more active patients. With the current replacement for thumb base arthritis the long term follow-up data is not yet available
Versatile use: This procedure is an option for a variety of joint sizes and locations, including the wrist, knuckles, and even thumb joints. Risk of complications: As with any surgery, there is a risk of infection, implant failure, or other complications that could affect the outcome.
Less strain on adjacent joints: Unlike joint fusion, joint replacement preserves motion, which reduces the likelihood of placing additional stress on surrounding joints. Longer recovery time: While motion is preserved, recovery and rehabilitation can take several months to fully regain strength and flexibility.

 

Joint replacement is a good option for individuals looking to relieve pain while maintaining joint flexibility and function. However, patients should consider the potential for implant wear over time, particularly if they are highly active.

While synovectomy can significantly reduce pain and inflammation, it’s not a permanent cure for rheumatoid arthritis. The inflammation can return, and in some cases, further treatments or surgeries may be needed down the line. However, for many patients, the procedure offers a welcome relief from pain and stiffness, allowing them to enjoy improved hand function and a better quality of life.

Denervation of arthritic joints (Also called Neurectomy)

Denervation of small joints in the hand is a surgical procedure aimed at alleviating chronic pain caused by conditions such as osteoarthritis or rheumatoid arthritis. Denervation provides an option for pain relief by targeting the sensory nerves that transmit pain signals from the affected joint to the brain.

 

Benefits Limitations
Effective Pain Relief

Denervation can significantly reduce or even eliminate pain in the affected joints. This can help restore hand function and improve quality of life.

No Impact on Disease Progression

While denervation reduces pain, it does not address the underlying arthritis. The joints will continue to wear down and become more damaged over time.

Minimally Invasive

Compared to other surgical options, such as joint fusion or joint replacement, denervation is a less invasive procedure. The incisions are small, and the recovery time is much faster. Most patients can return to light activities within a few days and full use of their hands within a few weeks.

Incomplete Pain Relief

Although denervation is very effective particularly in long fingers arthritis, it may not provide complete relief for every patient. Some individuals experience only partial pain reduction, and others may still have pain from other sources, such as inflammation in nearby joints or tissues.

Preservation of Joint Mobility

Unlike joint fusion, which involves immobilizing the joint to relieve pain, denervation allows the joint to retain its range of motion. This is a significant advantage for patients who rely on finger movement for fine motor tasks or who wish to maintain their grip strength.

Potential for pain to return

Over time, the divided nerves can regenerate and reconnect, which may result in a return of pain. While this regrowth can take months to years, it’s important to understand that the procedure may need to be repeated if symptoms return.

Fast Recovery and Return to Normal activities

Because denervation does not involve altering the joint itself, the recovery time is shorter compared to more invasive surgeries like joint replacement. Most patients experience only mild swelling and discomfort after the procedure, which resolves within a few days.

Potential Risks and Complications

As with any surgical procedure, there are some risks associated with denervation. These include infection, bleeding, temporary numbness or tingling in the fingers, or the development of scar tissue around the treated area. In rare cases, denervation can result in complex regional pain syndrome (CRPS), a chronic pain condition.

 

Denervation of small joints in the hand is a valuable option for individuals suffering from arthritis-related pain who are looking for an alternative to allow for fast recovery and return to normal activities. It offers effective pain relief while preserving joint function and is particularly beneficial for patients who wish to avoid joint fusion or replacement surgery. However, it is important to recognize that the procedure is not a cure for arthritis, and the effects may be temporary due to nerve regrowth. Patients should discuss the risks, benefits, and alternatives with their healthcare provider to determine if denervation is the right option for them.

Synovectomy

A synovectomy is a surgical procedure aimed at reducing pain and improving joint function by removing the inflamed synovial tissue, particularly useful in patients with rheumatoid arthritis. The synovial membrane lines the joints and produces synovial fluid, which helps lubricate the joint for smooth movement. In conditions like rheumatoid arthritis, this membrane becomes inflamed and thickened, causing pain, swelling, and damage to the surrounding joint structures. The synovectomy used to be a very common procedures in patients with rheumatoid arthritis, but these days is rarely done because of the new generation of drugs preventing the synovitis very effectively.

In a synovectomy, the surgeon removes the inflamed synovial tissue, helping to reduce the pain and prevent further damage to the joint. This procedure is particularly beneficial for people with rheumatoid arthritis, as the chronic inflammation in this condition can severely damage the joints over time. By removing the inflamed tissue, synovectomy can help improve the range of motion and function in the affected joints, whether it’s in the hands, wrists, or other areas.

How Successful is Hand Surgery for Arthritis?

How Successful Is Hand Surgery for Arthritis

Hand surgery for arthritis can be highly successful, particularly when performed by experienced surgeons.

Success Rates for Joint Fusion (Arthrodesis)

Joint fusion, or arthrodesis, is commonly used to treat severe arthritis in the smaller joints of the hand, such as the fingers and thumb. This procedure has consistently high success rates:

Studies show that joint fusion results in successful long-term pain relief for around 85–95% of patients. This is because the bones in the fused joint no longer move, eliminating the friction that causes arthritis pain.

Furthermore, joint fusion is highly effective in stabilising the joint, making it a durable solution. The fused joint will not wear out over time, offering a permanent solution for pain relief.

Around 90% of patients report being satisfied with the outcome of the surgery, primarily due to the significant reduction in pain. Despite the high success rate, it’s important to note that joint fusion eliminates movement in the affected joint. For patients whose primary concern is pain relief, this is often a worthwhile trade-off, but for others, the lack of mobility can be a limitation.

Success Rates for Joint Replacement (Arthroplasty)

Joint replacement, or arthroplasty, is another popular option, especially for larger joints like the wrist or knuckles, where maintaining motion is critical. The artificial joint allows for continued flexibility, making it easier for patients to perform everyday tasks. The success rates for joint replacement surgery are also very favourable, providing pain relief and restoring movement in 80–90% of cases.

However, the implant failure rates based on a review of large number of patients can be high, ranging from 2% to 20% (1 in 5 patients), depending on the prothesis used.  The artificial joint allows for continued flexibility, making it easier for patients to perform everyday tasks.

Most artificial joints last 10–15 years before any significant wear and tear occurs. One of most modern joint replacements for thumb arthritis,Maia, has a 5-year survival rate of 90%, meaning 1 in 10 patients will need to have a revision surgery in this time period. )In younger, more active patients, the artificial joint may wear out sooner, but for most people, the joint will provide many years of improved function before needing revision surgery.

Success Rates for Joint Denervation (Neurectomy)

How Successful Is Hand Surgery for Arthritis

The joint denervation compares to the arthroplasty and joint fusion in terms of outcomes but allows for expedite return to the activities of everyday life. The success rates depend on the joint treated and for the long fingers are 96% for knuckles, 80% success for PIP joint (the middle joint on the finger) and 100% for the DIP joint (the joint closest to the nail.

One study compared arthroplasty and denervation in thumb joint arthritis and found that the patient had the same results in terms of alleviating the pain and hand function but the return to to function was 3.3 weeks in denervation patients versus 4.5 months in arthroplasty group.

Factors That Affect Success Rates

While both joint fusion and joint replacement surgeries can be highly successful, their outcomes can be influenced by several factors. These include:

Type of Arthritis

The specific type of arthritis you have can play a role in how successful the surgery will be. Patients with osteoarthritis tend to have better outcomes from surgery compared to those with rheumatoid arthritis. This is because osteoarthritis usually affects fewer joints and causes less widespread inflammation, making surgical intervention more straightforward. 

Rheumatoid arthritis, on the other hand, is a systemic autoimmune condition that can affect multiple joints and cause more extensive damage, which can complicate surgery and affect long-term results.

Patient Age and Health

Age and overall health are also important factors that can influence the success of hand surgery for arthritis. Younger, healthier patients typically experience faster recovery times and longer-lasting results from surgery. Older patients or those with other health conditions, such as diabetes or circulatory issues, may have a slower recovery process and could face higher risks of complications. 

However, even older patients often see significant improvements in pain and function after surgery, particularly if they follow post-operative care guidelines closely.

Surgeon Experience:

The skill and experience of your surgeon are critical to the success of your hand surgery. Surgeons who specialise in arthritis-related procedures and have extensive experience in hand surgery tend to have higher success rates. A highly skilled surgeon can not only perform the procedure with greater precision but also manage any complications that may arise, ensuring a smoother recovery process.

What Can You Expect in Terms of Pain Relief?

Most patients experience significant pain relief after surgery, but recovery times can vary. While some patients notice immediate improvements, others may experience gradual relief over several months.

What Are the Risks and Complications of Hand Surgery for Arthritis?

How Successful Is Hand Surgery for Arthritis

As with any surgery, there are risks involved. While complications are rare, it’s important to understand them before deciding on surgery.

Common Risks Associated with Hand Surgery

    • Infection – As with any surgery, there’s a risk of infection. Your doctor will provide a list of signs to look out for, with guidance to seek medical attention if you believe you might have an infection.
    • Scarring – Some degree of scarring is unavoidable after surgery.
    • Reduced range of motion and stiffness – In some cases, surgery may lead to a loss of flexibility or motion. Often, this is considered a trade-off for reduced pain.
  • Failure to completely relieve the pain or recurrence fo the pain
  • Chronic regional pain syndrome – a painful condition where not only the are where the operation was done is painful but the whole hand and sometimes also the forearm get painful and swollen. This is very 
  • Blood clots – Although uncommon, blood clots are another potential complication of surgery.

To minimise your risks, be sure to choose an experienced surgeon, follow post-surgery care instructions, and monitor your own health closely. If you have any concerns, report them to your doctor.

Why You Might Want to Consider Hand Surgery for Arthritis

How Successful Is Hand Surgery for Arthritis

While surgery might feel like a big step, it can significantly improve your quality of life.

Improving Quality of Life

Surgery can restore function in your hands, allowing you to regain independence in everyday activities such as cooking, dressing, and typing.

Relief from Chronic Pain

For many patients, the biggest benefit of surgery is pain relief. Living without the constant ache and stiffness of arthritis can dramatically improve your overall well-being and mental health.

Preventing Further Joint Damage

Addressing arthritis with surgery can prevent further joint deterioration, especially if done at an early stage. Waiting too long may limit your surgical options, so early intervention is often key.

What to Expect During Recovery After Hand Surgery

How Successful Is Hand Surgery for Arthritis

Recovering from hand surgery for arthritis varies depending on the type of surgery you undergo.

Immediate Post-Surgery Care

You may experience swelling and discomfort immediately after surgery, but your surgeon will provide instructions to help manage these symptoms. Healing typically takes a few weeks to months, depending on the complexity of the surgery.

Remember: healing takes time. While you’re recovering, be sure to take it easy and reduce strain on the joint, even if it’s inconvenient. 

Physical Therapy and Rehabilitation

Rehabilitation is a crucial part of your recovery. Physical therapy can help you regain strength, flexibility, and mobility in your hand. 

You may have regular sessions with a physical therapist, who can give you safe exercises to complete at home to ensure your surgery is successful in the long term.

Long-Term Recovery

Many patients see continued improvements for up to a year after surgery. Long-term outcomes depend on how closely you follow your post-operative care plan and physical therapy routine.

Frequently Asked Questions About Hand Surgery for Arthritis

Is Hand Surgery a Permanent Fix?

While hand surgery can offer long-term relief, it’s not always a permanent fix. Arthritis may progress, and some patients may require additional surgeries down the line.

How Long Does It Take to See Results After Surgery?

Results can vary, but many patients notice significant improvements in pain and mobility within 6 to 12 weeks of surgery.

Will I Need More Than One Surgery?

In some cases, arthritis can continue to progress, and additional surgeries might be necessary. However, many patients experience long-lasting relief from their initial procedure.

Conclusion

How Successful Is Hand Surgery for Arthritis

Hand surgery for arthritis can be a successful option for many people, offering pain relief and improved hand function when non-surgical treatments aren’t enough. While every surgery has its risks, the benefits of restored mobility and reduced pain often outweigh the drawbacks.

If you’re considering hand surgery for arthritis, it’s important to consult a specialist to explore your options. At the Nerve Surgery Centre, we offer expert advice and personalised care to help you make the best decision for your health. Contact us today to book an appointment and take the first step towards a pain-free life.

References

  1. Hustedt JW, Deeyor ST, Hui CH, Vohra A, Llanes AC, Silvestri BL. A Prospective Clinical Trial Comparing Denervation With Suspension Arthroplasty for Treatment of Carpometacarpal Arthritis of the Thumb. J Hand Surg [Internet] 2023 [cited 11 Jul 2024];48(4):348–353. 
  2. Tieman TE, Duraku LS, Oest MJW van der, Hundepool CA, Selles RW, Zuidam JM. Denervation of the Joints of the Hand and Wrist: Surgical Techniques and a Systematic Review with Meta-Analysis. Plast Reconstr Surg 2021;148(6):959e–972e. 
  3. Gandolfi S, Carloni R, Mouton J, Auquit-Auckbur I. Finger joint denervation in hand osteoarthritis: Indications, surgical techniques and outcomes. A systematic review of published cases. Hand Surg Rehabil 2020;39(4):239–250. 
  4. Holme TJ, Karbowiak M, Clements J, Sharma R, Craik J, Ellahee N. Thumb CMCJ prosthetic total joint replacement: a systematic review. EFORT Open Rev 2021;6(5):316–330. 
  5. Andrzejewski A, Ledoux P. Maïa® trapeziometacarpal joint arthroplasty: Survival and clinical outcomes at 5 years’ follow-up. Hand Surg Rehabil 2019;38(3):169–173.

Medically Reviewed by Mr Tomas Madura:

Mr Tomas Madura MD(Hons), PhD, FRCS(Plast), is a highly experienced Consultant Plastic Surgeon specialising in hand and peripheral nerve surgery, with over two decades in the medical field. He has been a Consultant at the Birmingham Hand Centre and Brachial Plexus and Peripheral Nerve Injury Service at the Queen Elizabeth Hospital in Birmingham since 2017. Mr Madura’s distinguished career includes a PhD in Neurobiology from Osaka University, multiple fellowships in reconstructive microsurgery and peripheral nerve surgery, and numerous contributions to research in the field of nerve injuries and paralysis.

He is a Fellow of the Royal College of Surgeons of Edinburgh and a full member of several prestigious organisations, including the British Association of Plastic Reconstructive and Aesthetic Surgeons and the British Society for Surgery of the Hand. Mr Madura has been recognised with the Syme Medal for outstanding contributions to surgical research.

For more information, please visit his About page.

 

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