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I'm exploring various treatment options for my hand arthritis. The middle joints of both hands are affected the worst. Making a fist is impossible somedays. On other days, I can make a fist but I can't open my fingers. If I had joint implants would I be trading one trouble for another? I've heard they aren't all that reliable.

Right now, the middle joints of the fingers (called the proximal interphalangeal (PIPs) joints have the best long-term track record for success with implants. The implants are made of silicone (a type of rubber) or pyocarbon (a carbon-based material). Both materials are flexible and durable enough to function in the fingers. But there have been some problems. Implant fracture and loosening head the list of reasons why implants fail. There can be a settling of the implant down into the bone -- a little bit of settling is okay and to be expected. But too much sinking and problems with joint instability develop. Other problems that have been reported include squeaking, dislocating, and contractures (the joint gets stuck in one position and won't move). Overall results of joint implants is quite good in terms of relief of painful symptoms and improvement in hand function. But much more work needs to be done to figure out why problems develop and how to prevent them.

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