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Decades of Finger Implants

Small Joint Surgery Is Treatment Option, But Not a Perfect Solution for All

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Updated June 01, 2014

Joint replacement is recognized as a treatment option for large joints which have been severely damaged by arthritis. Painful, deformed, and limited small joints can also be helped by implant replacement.

Finger joint implants have been an option for decades. Since 1969, over 500,000 implants have replaced damaged finger, wrist, and toe joints in people from 86 different countries. The small joint implant was developed by Alfred B. Swanson, M.D., an orthopaedic surgeon, hand surgeon, and scientist from Grand Rapids, Michigan.

Dr. Swanson first became interested in joint replacement in 1950 after assisting with the development of a total hip implant while training at Indiana University. Swanson's interest continued during his time as an Army surgeon and while in private practice. Unsuccessful and unpredictable results with small joint surgery inspired him to devise a better method.

  • In 1962, Swanson assembled a research department at Blodgett Hospital in Michigan to test the use of silicone for small joint implants.
  • By 1964 the first patient was operated on using the silicone implants.
  • By 1969, following more research and study results, the finger implant was approved and became officially available.
  • Swanson later developed implants for the wrist and great toe joints as well.

Small joint implant surgery involves bone shaping, insertion of the implant, and rebalancing of surrounding joint tissues. The Swanson implant acts as a flexible hinge. Since the structure of the implant does not precisely replicate the biomechanics of the joint it replaces, full function is not restored. In actuality, between 30 and 40 degrees range of motion is considered achievable with the surgery as compared to 90 degrees range of motion in a normal hand.

Since full function is not restored, finger implant surgery is not considered the first choice of treatment. More conservative measures to diminish pain and restore function are encouraged prior to considering surgery including exercise, assistive devices including splints, hot and cold treatments, and medications. The surgery is not considered an option for solely cosmetic purposes. Each individual patient must consider the potential gain versus the risk of complications.

Finger implant surgery is not regarded as a perfect solution nor as a solution for everyone. The surgery is most valuable for patients who will regain function and who will benefit greatly from achievable pain relief.

During the 1980's I visited hand surgeons on three different occasions for an assessment of the damage which was done to my hands by rheumatoid arthritis. Since I did not complain greatly of pain and still had adequate function remaining, the surgeons decided finger implant surgery was not a valid treatment for me. Their decision always puzzled me since I was looking for something to fix my twisted and contracted hands. However, as previously stated, it is foremost an option to restore function and relieve pain, and those were not my primary complaints.

Excellent Links About Hand Surgery:
Electronic Textbook of Hand Surgery
Anatomy of the Hand

Sources:

Breakthrough Treatment For Hands, Wrists, Toes Marks Three Decades, PRNewswire

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