This handout explains the follow-up care after joint replacement (arthroplasty) of the metacarpophalangeal (MCP) joint. During surgery, the painful and arthritic joint was replaced with new components to allow the joint to move without pain. A splint has been used to maintain your fingers in as straight a position as possible. If the splint feels tight, it’s okay to unwrap and rewrap the Ace bandages. Because of the local anesthetic that we used, you may notice a numbness or tingling sensation in your fingers for several hours. This is normal and should dissipate within a few days.

If the skin around the incision is red or if there is drainage coming out of it please call us right away. The phone number is at the bottom of this page. Go to the emergency room if this occurs at night or on a weekend. We recommend that you start physical therapy within 2-3 days after surgery to introduce gentle range of motion exercises. If you do not have an appointment to begin post-operative therapy, please contact our office and we will coordinate that for you.

Wound Care:

  • A joint prosthesis (hardware) is used to replace this joint. This recreates the normal sliding surface of the joint.
  • After surgery, your hand will be placed in a bulky splint. This helps to protect the joint replacement and lessen the swelling. When bathing, put a plastic bag around your hand to keep the splint clean and dry.
  • Elevate your hand as much as possible to lessen the swelling and pain during the healing process.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take the pain medication as it is prescribed, taking the right dose at the right time to best manage your pain. As it takes about 1 hour for the medication to take effect, it is important to “stay ahead” with your pain medication and avoid having to play “catch up” for a significant increase in pain.
  • Medication for nausea may also be provided. Please make sure to take this as directed, typically placed under the tongue (sublingual) to be absorbed in the mouth.
  • Please make sure to check with the postoperative nurse or the Bellevue Bone & Joint Physicians staff about how to manage your pain medication.
  • Please see the “Medications After Surgery” form for more instructions.
  • If you have uncomfortable side effects from the pain medication please call us.
  • It is normal to have some pain off and on for approximately one year after surgery particularly in cold weather.

Driving:

  • Do not drive if you are taking narcotic medication, as it is unsafe and against Washington state law. Taking medication can make you sleepy and delay your reaction time.
  • Once you are no longer taking narcotic medication you may drive as soon as you can comfortably grip the steering wheel with both hands.

Activity:

  • You have very little use of the operative hand for about six weeks after surgery until the tissue heals.
  • Do not lift anything heavier than a pencil or pen until your sutures have been removed and you have been advised to advance your activity by your physician or therapist.

Follow-Up:

  • Schedule an office visit with hand therapy within 3 days following surgery.
  • The sutures will be removed beginning 10-14 days after surgery.
  • Your hand will be placed in a splint to protect against excessive range of motion.
  • A hand therapist will help to teach you exercises to lessen the scarring around the incision, improve range of motion, and when appropriate increase your hand and arm strength.

Results:

Many patients who have their MCP joint replaced will regain full use of their hand. Stiffness is common after surgery and decreases with use. Hypersensitivity at the surgical scar can be reduced by rubbing the skin using materials with different textures.


Thomas E. Trumble, M.D.

*Figures courtesy of Principles of Hand Surgery and Therapy by Thomas E. Trumble, MD, Ghazi M. Rayan, MD, Mark E. Baratz, MD and Jeffrey E. Budoff, MD