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Hand Therapy Department
Ipswich Hospital
01473 703 312

MCPJ replacement advice (swanson) for rheumatoid arthritis

You have had surgery to replace one or more of your knuckle (MCP) joints. This will help to reduce your symptoms of pain and swelling, and improve the position of the fingers. Most patients find that their new joints do not allow quite as much movement as before surgery but this should not affect your function.

7 to 10 Days Post-Surgery

Your theatre dressings will be removed, and you will have one (or possibly both) of the following splints made for you:

• A forearm-based resting splint to wear overnight, which includes your fingers and wrist. This splint should be worn overnight for at least 6 weeks
• A forearm-based resting splint to wear in the day, with the big knuckles held straight but the smaller finger joints free

You will need to carry out the following finger exercises; you do not need to remove your splint to do these:

Hold each position for 4 seconds, and repeat four times. Please carry these out four times per day.

You will also need to carry out regular scar massage as shown by your hand therapist, for 4 minutes, four times per day.

If your hand swells, you should elevate it above heart height to help bring down any swelling.

3 Weeks Post-Surgery

Continue with your scar massage three times per day.

Please bring both splints with you to your appointment, as they may need to be adjusted.

Continue with your exercises four times per day.

6 Weeks Post-Surgery

You will be reviewed again in hand therapy and will be taught a new exercise:

• Make a fist and hold for 4 seconds. Repeat this 4 times in one go, and carry it out four times per day.

You may now stop using your day splint.

You may use your hand for light function, for example using cutlery, drinking a cup of tea and getting dressed.

8 to 9 Weeks Post-Surgery

Continue with your exercises four times per day.

You are aiming to achieve 15 to 80 degrees at the operated joint by eight weeks.

If you can straighten your operated knuckle to 15 degrees, you will be advised to stop using your night splint.

12 Weeks Post-Surgery

You can now return to most activities. However, you are advised to permanently avoid heavy activities such as digging due to the stresses this puts through the replaced joints.

Pain relief

Taking regular pain relief medication can help reduce your pain, improve your sleep and enable you to complete your exercises more effectively. Please make sure you follow the instructions on the packet.

General advice

There are several lifestyle factors that can impact your general wellbeing and your body’s ability to heal. These include a healthy balanced diet, regular exercise and getting a good night’s sleep. Stopping smoking, and drinking no more than the recommended limits of alcohol could also improve your overall healing.

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