Houston Methodist. Leading Medicine

Hand FAQ

Question:

After years of suffering from a painful hand that wouldn't open and close properly, I finally had two finger joint replacements. One finger has done beautifully. But the other one squeaks! Every time I bend or straighten my middle finger, there is an honest-to-god squeak. What is the world is this?

Answer:

Anyone who has suffered the long-term effects of arthritis knows how pain can result in loss of motion and function. The quality of life can really suffer over the loss of a normal, healthy finger joint! Joint replacement is possible now for all three joints of the four fingers (index, middle, ring, pinkie). Those joints are made up of the metacarpal phalangeal (MCP or the large knuckle), the proximal interphalangeal joint (PIP), and the distal interphalangeal joint (DIP). The proximal interphalangeal joint is the joint in the middle of the finger between the knuckle and the tip of the finger. But as with all joint replacements, problems can develop. If the implant isn't in good alignment, it can slip out of place causing dislocation and even fracture. Sometimes the implants sink down into the bone, a process referred to as subsidence. Squeaking has also been reported by some patients. In fact, it is the third most common complication (after implant loosening and finger stiffening). Implants made of pyrolytic carbon tend to squeak more than silicone joint replacements. And as you have discovered, the squeak can be loud enough to be heard by others. The best thing to do is let your surgeon take a look and see if he or she can offer any solutions. But beware there's probably not much that can be done about the problem short of removing and replacing the implant with a different type of joint replacement. Removing the implant and fusing the finger is an option but this approach results in no motion and therefore loss of function for pinching and gripping objects. Thomas M. Sweets, MBA, MD, and Peter J. Stern, MD. Pyrolytic Carbon Resurfacing Arthroplasty for Osteoarthritis of the Proximal Interphalangeal Joint of the Finger. In The Journal of Bone and Joint Surgery. August 3, 2011. Vol. 93-A. No. 15. Pp. 1417-1425.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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