Complications of MCP joint replacements

The specific complications of MCP joint replacement in rheumatoid arthritis are as follows:

1. Poor wound healing - the skin on the back of the hand over the MCP joints is naturally thinner than palmar skin. It is often even thinner in patients with longstanding rheumatoid arthritis. This increases the risk of wound breakdown though in my own practice this risk has been less than 5%.
2. Infection - with somewhat potentially poorer quality skin the risk of infection is increased. Elevation in the post-operative period is a critical factor in helping to reduce this complication.
3. Failure of the implant - This is always a risk but current evidence suggests that it may take 10 - 15 years before it happens. If it does occur then it may be possible to simply replace the broken prosthesis.
4. Silicone synovitis - there is a small risk that small particles from the silicone prosthesis cause a reaction in the tissues (synovitis) giving rise to an inflammatory reaction. This is fortunately an extremely rare complication with this type of silicone prosthesis.