Melbourne Hand Surgery 

Please note: We do our best to accommodate emergency and urgent referrals upon receipt of your doctor's referral. Dr Tomlinson is currently booked some months in advance so if your condition is urgent or you wish to be placed on our "Waiting for an Early Appointment" list to see Dr Tomlinson or Mr Babazadeh please provide us with your doctor's referral and your registration forms so that we can facilitate an urgent review. We strongly encourage individuals who are seeking non-surgical treatment of Dupuytren's contracture with Dr Tomlinson to seek placement on our waiting list and provide us with details of your availability, so that we can contact you in the event of an earlier appointment becoming available. If you have recently sustained a hand or wrist injury you may wish to explore the option of the Action Rehab Urgent Care Clinic, where your injury will be assessed and managed by an experienced hand therapist.

Joint replacement (arthroplasty)

Joint replacement in the hand and wrist can provide improvement in pain and occasionally in range of joint motion for patients with osteoarthritis arthritis, rheumatoid arthritis and post traumatic arthritis.

Is it suitable for me?

elderly hands

Joint replacement in the hand and wrist is not suitable for everyone. In many instances the soft tissue and bone changes associated with rheumatoid arthritis may make the surgery inadvisable. Joint replacement in the fingers is inadvisable if there is a lack of bone, inadequate bone configuration, poor soft tissues or chronic infection.

When joint replacement is not possible fusion of the joint may be appropriate. A joint that has been fused no longer moves, but this may be a welcome relief if it provides significant pain relief.

Choice of prosthesis

Joint replacement (implant arthroplasty) remains a challenging area of hand surgery and many questions and problems relating to it are still being studied. There are prostheses available for finger joints, the metacarpophalangeal (knuckle) joints, the trapeziometacarpal joint (at the base of the thumb), the distal ulnar head and the wrist, as well as resurfacing hemiprostheses for the scaphoid and capitate. The prostheses are predominantly made of titanium or pyrocarbon.

Some of these prostheses have not been used in large numbers and their lifespan is uncertain, so it is usual for surgeons to follow patients closely (with clinical review and X-rays) so that results can be audited and any problems that relate to a specific prosthesis are detected early. In recent years unsatisfactory follow-up results have enabled surgeons to choose a prosthesis or surgical technique that provides better outcomes. As time goes on we will continue to develop increasingly reliable techniques and prostheses, to the benefit of current and future patients.

Post operative hand therapy

fingers walking up book staircase

Post operative hand therapy is extremely important, particularly in preventing joint stiffness. Reviews of multiple patients show that some have an increased range of movement after surgery, some have the same, and some have a reduced range of movement. Consistently performing your exercises exactly as your therapist instructs will increase the likelihood of an excellent outcome. The post operative therapy protocol lasts at least 6 weeks.


Potential complications of joint replacement in the fingers include failure to relieve pre-operative pain, failure to improve or maintain the joint range of movement (your joint may have a reduced range of movement after the surgery), injury to the extensor tendon causing inability to fully extend the joint, infection (which in severe cases may require lifelong antibiotics, removal of the prosthesis or amputation of your finger), loosening of the prosthesis requiring revisional surgery, wound healing problems, dislocation or subluxation of the joint, implant fracture, finger deformity and joint contracture.


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