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Hand and foot surgery · UK

Small joint replacement - silicone and pyrocarbon implants for hand and foot joints.

Consultant hand and foot surgeons for finger PIP and MCP joints, thumb CMC and great-toe MTP replacements ’ restoring pain-free movement in the small joints that arthritis, trauma or inflammatory disease has worn out.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private small joint replacement surgery costs in the UK.

Indicative ranges across our partner units.

In short

£6,500–£9,500, home the same day.

Option Indicative range
Consultation with X-ray review £220–£400
PIP joint replacement £6,500–£9,500
MCP joint replacement £6,800–£9,800
Thumb CMC joint replacement £7,500–£11,500
Great-toe MTP joint replacement £7,000–£10,500
Bilateral or multi-joint case £11,500–£17,500
Post-op hand or foot therapy package £450–£900

Prices vary by site, by complexity, and by whether add-on care is needed.

The problem

The right joint, the right implant, and therapy that starts before the operation.

Small joint work is where private clinics quietly under-deliver ’ imaging skimmed, implant chosen for the surgeon’s inventory, and therapy left to hope.

  • Confirm the joint

    Not every finger ache needs replacement. We see the X-ray, examine the joint and often try injection or splinting first.

  • Pick the right implant

  • Plan the therapy

    Hand or foot therapist assesses grip and splint before the operation. First appointment booked before you leave the ward.

When it helps

When small joint replacement is the right step.

The presentations where replacement makes sense, and the red flag that means A&E, not a private appointment.

  • Painful finger osteoarthritis

    Nodal osteoarthritis of the PIP or MCP joints that no longer settles with splints, gel or injections.

  • Rheumatoid MCP joints

    Rheumatoid destruction of the MCP joints with ulnar drift ’ replacement restores alignment and grip.

  • Thumb-base arthritis

    Painful CMC osteoarthritis after injections and splinting have failed ’ replacement, trapeziectomy or fusion.

  • Post-traumatic joint destruction

    A single joint destroyed by an old fracture ’ replacement can restore movement where fusion loses it.

  • Hallux rigidus

    End-stage great-toe MTP arthritis with rigid dorsal spurs and painful push-off.

  • Deformity correction

    Angulated or subluxed joints where realignment is part of the operation.

  • Failed previous surgery

    A failed fusion, cheilectomy or previous implant that can be revised to a modern implant.

  • Red flag: acutely hot, swollen joint

    A red, hot, swollen small joint with fever needs same-day rheumatology or A&E to exclude infection, not a routine appointment.

Procedure options

The approach depends on the joint.

Different joints suit different implants ’ here is how each option compares.

  • Silicone PIP replacement

    Long-standing implant with a strong track record ’ good pain relief, modest arc of movement.

  • Pyrocarbon PIP replacement

    A stronger, more anatomical implant offering greater movement ’ appropriate in selected patients.

  • Silicone MCP replacement

    The standard for rheumatoid MCP joints ’ corrects deformity and restores useful grip.

  • Thumb CMC replacement

    Modern total joint replacements have caught up with trapeziectomy ’ faster recovery, comparable results.

  • Toe MTP replacement

    Silicone or metal-poly implants for end-stage hallux rigidus where fusion would sacrifice too much movement.

  • Fusion (arthrodesis)

    A time-tested alternative ’ predictable pain relief but no movement. First choice for very high-demand hands.

  • Cheilectomy or debridement

    A joint-preserving option earlier in the disease ’ removes bone spurs and buys time.

  • Steroid or hyaluronic acid injection

    Non-surgical option for mild to moderate arthritis or where surgery is not appropriate.

Safety and recovery

What to expect afterwards - honestly.

Small joint replacement is safe in experienced hands. The details that matter are implant choice, splinting and the six weeks of therapy that follow.

  • Regional or general anaesthetic

    Most cases are done under a regional block ’ excellent pain relief and no full anaesthetic recovery.

  • Infection

    Deep infection is rare (under 1 percent). Single-dose antibiotics on induction. Antibiotics only afterwards if signs develop.

  • Stiffness

    The commonest reason for a disappointing result. Hand or foot therapy for six weeks is the single best predictor of outcome.

  • Implant loosening

    5–10 percent at ten years for silicone implants ’ often silent and manageable. Pyrocarbon has a similar profile.

  • Implant fracture

    A recognised silicone failure mode over time. Usually revised to a new implant or a fusion.

  • Nerve or tendon injury

    Rare. A named consultant knows the anatomy and stays out of trouble.

  • Persistent pain

    A minority of patients have some ache in the operated joint. Injections or revision are options.

  • Deformity recurrence

    Especially in rheumatoid MCP joints ’ splinting and therapy for the first three months limit this.

  • Red flags after surgery

    Spreading redness, fever, uncontrolled pain or numb fingers/toes needs the same-day team, not a routine call.

Reading your notes

Your notes in four parts. Read the last one first.

Whether it is a single finger replacement or a multi-joint rheumatoid case, the operation note and therapy plan keep to the same shape.

A UK consultant reviewing a patient’s notes

A quiet reminder

Hand and foot notes are precise ’ we translate them for you.

If you want us to walk you through the operation note, implant type and therapy schedule before your review, just ask.

  1. 01 Header

    Joint, implant and side

    Date, consultant, joint operated, implant type (silicone, pyrocarbon, total joint) and size, and anaesthetic used.

  2. 02 Findings

    Intra-operative findings

    State of the joint surfaces, ligament condition, any deformity correction performed.

  3. 03 Histology

    Synovium and bone

    Where sent, pathology of synovial tissue ’ osteoarthritis, rheumatoid, or an unexpected finding.

  4. 04 Impression

    Therapy and follow-up

    Read this first: splint schedule, first therapy appointment, return-to-activity milestones and review timings.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Medically indicated joint replacement is covered by most policies.

Frequently asked

Everything we get asked about small joint replacement surgery.

Quick answers on cost, implant choice, recovery and how long the joint will last.

  • How much does private small joint replacement cost in the UK?

    A single PIP or MCP replacement typically costs £6,500–£9,500 self-pay in 2026, thumb CMC £7,500–£11,500 and great-toe MTP £7,000–£10,500. All-inclusive packages cover consultation, surgery, day-case admission and short-term follow-up.

  • Should I have a replacement or a fusion?

    Replacement preserves movement and is a good choice for most PIP, MCP and thumb joints. Fusion sacrifices movement but is very reliable and better for very high-demand hands or repeat failure. Your consultant will explain the trade-offs.

  • How long is recovery after finger joint replacement?

    Home the same day. A splint for 2–4 weeks, hand therapy weekly for six weeks, back to typing at 2–4 weeks and to sport at 12 weeks. Full benefit at 6–9 months.

  • Silicone or pyrocarbon ’ which is better?

    Silicone has decades of data and remains the standard for rheumatoid MCP joints. Pyrocarbon offers more movement in selected osteoarthritis PIP joints. Your consultant will match implant to joint and demand.

  • How long does a small joint implant last?

    Around 85–90 percent of silicone implants are still in place at ten years, though not always symptom-free. Modern pyrocarbon and total joint thumb implants have similar early data.

  • Does the NHS offer these operations, and why go private?

    Yes ’ small joint replacements are available on the NHS but waits are long and implant choice restricted. Private routes are used for speed, choice of consultant, choice of implant and dedicated hand or foot therapy.

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