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Artificial metacarpophalangeal and interphalangeal joint replacement for end-stage arthritis

Guidance issued Guidance issued
 
IP Guidance Number: IPG110
 
Summary:

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on artificial metacarpophalangeal and interphalangeal joint replacement for end-stage arthritis.

Description:

This procedure is used to treat osteoarthritis of the hand. Common sites of osteoarthritis which may be suitable for artificial implants include the wrist, the carpometacarpal joint of the thumb (also called trapeziometacarpal joint) and the metacarpophalangeal and interphalangeal joints of the fingers and thumb. Osteoarthritis of hand joints is a common condition which deteriorates over time, although severity of symptoms, rate of deterioration and functional effects are variable.

The surgeon removes the diseased joints in an open operation and replaces them with an implant, typically made of a silicone based material. A range of implants from different manufacturers are available for different joints.

Other treatments for osteoarthritis of the hand include conservative management with anti-inflammatory and analgesic medication; complete joint excision (also called excision arthroplasty); fusion of the joint (arthrodesis); and native graft arthroplasties, in which the patient's own tissue (typically tendons) is interposed in the space left after joint excision.

There are no routinely available data on the number of procedures carried out in the UK each year on hand joints.

Arrangements:

Other (see guidance)

Topic Area:

Musculoskeletal
Surgical procedures

Specialty:

Plastic surgery
Rheumatology
Trauma and orthopaedic surgery

Specialist advice has
been sought from:
British Society for Surgery of the Hand
Date notified to NICE: 01 April 2002
Provisional Consultation Date: November 2004
Guidance Publication Date: 23 February 2005
Contact Details:
Project Manager
(for general enquiries or comments)
Ben Doak
Contact Address:

Interventional Procedures Programme
National Institute for Health and Clinical Excellence
MidCity Place
71 High Holborn
London
WC1V 6NA


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