Table 2.

Small joint arthroplasty options for the hand

Arthroplasty Type	Indications	Advantages	Disadvantages
Silicone	MCPJ and PIPJ arthritis (OA, RA, post-traumatic)	Pain relief, technically straighforward	Minimal improvement in range of motion (better at MCPJ compared to PIPJ), subsidence, implant fracture
PIP-SRA	MCPJ and PIPJ arthritis (OA, post-traumatic)	Pain relief, minimal bone resection (maintain collaterals)	Minimal improvement in range of motion, subsidence, loosening, implant fracture
Pyrocarbon	MCPJ and PIPJ arthritis (post-traumatic, rarely OA) with adequate soft tissue support	Pain relief (controversial), improved grip/pinch strength	Minimal improvement in range of motion (better at MCPJ compared to PIPJ), subsidence, dislocation, implant fracture
Autologous	Skeletally immature patients with MCPJ and PIPJ trauma or adults with contraindication for prosthesis (inadequate soft tissue support, large bone deficit, previously failed prosthesis)	Allows future growth and composite reconstruction	Minimal improvement in range of motion, high complication rate, need for secondary surgery, technically challenging

MCPJ, metacarpophalangeal joint; PIPJ, proximal interphalangeal joint; OA, osteoarthritis; RA, rheumatoid arthritis