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Surgery for hand arthritis - keep the grip, lose the pain.

CMC (thumb base) arthroplasty, PIP and DIP fusion or replacement, wrist fusion or replacement - a consultant hand surgeon, a hand therapist named on day one, and the honest conversation about what surgery can and cannot restore.

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 hand arthritis surgery costs in the UK.

Indicative ranges across our partner hand-surgery units.

In short

Trapeziectomy with LRTI: £5,500–£8,500, home day-case.

Procedure Indicative range
Trapeziectomy with LRTI (CMC arthroplasty) £5,500–£8,500
Simple trapeziectomy £4,500–£6,800
PIP joint fusion (arthrodesis) £4,200–£6,500
DIP joint fusion £3,800–£5,800
Silicone or pyrocarbon PIP arthroplasty £6,500–£9,500
Partial or total wrist fusion £8,500–£13,500
Total wrist arthroplasty £12,000–£17,000
Hand surgery consultation only £220–£380

Prices vary by hospital, consultant and approach.

The problem

The joint decides the operation - not the surgeon’s favourite technique.

Hand arthritis surgery is where a good hand therapist is worth their weight, and where the wrong operation trades one problem for another.

  • Try the non-operative route properly first

    Custom splint, oral or topical anti-inflammatories, hand therapy and one or two guided steroid injections. Most CMC arthritis never comes to theatre.

  • Preserve motion where you can

    Fusion is bomb-proof for pain but takes movement; arthroplasty preserves it but has its own risks. The joint and your goals dictate which.

  • Plan the therapy before the surgery

    A named hand therapist, a written home programme and a splint fitted on the day - this is what determines a good result more than the operation itself.

When it helps

When surgery is the right step for hand arthritis.

The joints and situations we see most, plus the red flag that means A&E rather than an outpatient booking.

  • Base-of-thumb (CMC) osteoarthritis

    Pain pinching, opening jars, turning keys - with joint-line tenderness and a positive grind test.

  • Painful PIP osteoarthritis

    Painful, swollen middle finger joints with Bouchard nodes and loss of grip strength.

  • DIP osteoarthritis and mucous cysts

    Painful end joints with Heberden nodes; sometimes with fluid-filled mucous cysts that ache and catch.

  • Rheumatoid deformity

    Ulnar drift, boutonnière or swan-neck deformity that has failed disease-modifying therapy and is limiting hand function.

  • SLAC or SNAC wrist

    Scapholunate or scaphoid non-union advanced collapse - the wrist bones have started to grind.

  • Post-traumatic wrist arthritis

    Wrist pain after an old fracture or ligament injury, worse with load-bearing tasks.

  • Failed conservative treatment

    Splinting, therapy, oral and injected treatment have all been tried honestly and the joint is still the problem.

  • Red flag: rapidly deforming joint with red hot swelling

    Acute red, hot, swollen joint with fever needs septic arthritis excluded urgently - A&E, not a routine appointment.

Procedure options

Approach and implant depend on the joint and your hand.

Each option has a purpose - reliable pain relief, preserved motion, or restored deformity - and only the joint itself decides which fits.

  • Trapeziectomy with LRTI

    The workhorse for CMC arthritis. Trapezium removed, ligament reconstruction and tendon interposition - reliable pain relief, some pinch strength loss.

  • Simple trapeziectomy

    Trapezium alone. Slightly quicker recovery, comparable long-term outcomes in some series.

  • Suture-suspension arthroplasty

    Newer suture-button techniques - faster recovery, evolving evidence base.

  • PIP arthrodesis

    Fusion in a functional position. Pain-free, strong, no movement - the workhorse for index and middle finger PIPs.

  • PIP silicone or pyrocarbon replacement

    Preserves motion - best in ring and little fingers, radiographically stable at 5–10 years in selected patients.

  • DIP arthrodesis

    Small-plate or headless-screw fusion - reliable pain relief for painful end joints.

  • Partial wrist fusion

    Four-corner fusion or scaphoidectomy plus fusion for SLAC/SNAC. Keeps some radiocarpal motion.

  • Total wrist arthroplasty or total wrist fusion

    End-stage radiocarpal arthritis - arthroplasty preserves motion, fusion is more durable in heavy-hand workers.

Safety and recovery

What to expect afterwards - honestly.

Hand arthritis surgery is well-established. The things worth planning are the joint choice, the operation type, and the therapy plan.

  • Regional block or GA, day-case theatre

    A wide-awake block for many cases; GA where preferred. Home the same day for almost all hand-arthritis surgery.

  • Bleeding and infection

    Wound infection under 2 percent. Bleeding is uncommon on a hand tourniquet-controlled operation.

  • Nerve and tendon injury

    Small but real risk of digital nerve or tendon irritation - usually resolves with therapy.

  • Complex regional pain syndrome

    Rare (under 2 percent) but real - early aggressive therapy, elevation and pain control reduce risk.

  • Stiffness

    Every hand operation stiffens the joint before it eases. Therapy prevents the stiffness setting.

  • Non-union in fusions

    5–10 percent risk of non-union in finger fusions, higher in smokers - a good reason to stop before theatre.

  • Implant failure in arthroplasty

    Silicone and pyrocarbon PIPs have 10–15 percent revision rates at 10 years. Wrist replacements need revision more often than wrist fusions.

  • Pinch strength loss

    Trapeziectomy sacrifices some pinch strength for reliable pain relief. Worth naming before consent.

  • Red flags after surgery

    Fever, spreading redness, unrelenting pain, numbness or a cold blue finger - same-day team, not a routine call.

Reading your operation note

Your hand operation note in four parts. Read the last one first.

Whatever joint was operated on, the note the hand surgeon sends you keeps to the same shape.

A UK consultant hand surgeon reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the histology before your review, just ask.

  1. 01 Header

    Joint, operation and side

    Which joint was operated on, the specific technique, whether a splint was applied and for how long.

  2. 02 Technique

    Approach, implants and closure

    Skin incision, ligament reconstruction, implant type (silicone, pyrocarbon, plate, wires), and any tendon transfer.

  3. 03 Findings

    Cartilage, deformity and stability

    Actual state of the joint at surgery - cartilage loss, osteophytes, ligament laxity, tendon disease.

  4. 04 Impression

    Therapy plan and rehab timeline

    Read this first: splint duration, when to start therapy, driving and return-to-work window.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Hand arthritis surgery is usually covered when medically indicated with a failed conservative trial documented.

Frequently asked

Everything we get asked about hand arthritis surgery.

Quick answers on splints, fusion vs replacement, therapy, recovery and cost.

  • Do I definitely need surgery for thumb-base arthritis?

    No. Most CMC arthritis settles with a custom splint, hand therapy, oral or topical anti-inflammatories and one or two guided steroid injections. Surgery is for people whose pain and function have not responded to a fair non-operative trial - usually three to six months.

  • Fusion or replacement for finger arthritis?

    Fusion is bomb-proof - no pain, strong, no movement. Replacement preserves motion but has a 10–15 percent revision rate at ten years. Index and middle PIPs usually get fused (grip and pinch matter); ring and little PIPs are the better candidates for replacement.

  • How much does private hand arthritis surgery cost in the UK?

    Roughly £5,500–£8,500 for CMC arthroplasty with LRTI, £4,200–£6,500 for a PIP fusion, £6,500–£9,500 for silicone or pyrocarbon PIP replacement, £8,500–£13,500 for partial wrist fusion, £12,000–£17,000 for total wrist arthroplasty.

  • How long is recovery?

    CMC arthroplasty: splint 4–6 weeks, hand therapy from week 2, driving 6–8 weeks, full grip strength at 6–12 months. PIP fusion: splint 4 weeks, back to office work in 2–3 weeks. Wrist fusion or replacement: cast 6 weeks, return to heavy work at 3–4 months.

  • Will surgery restore my pre-arthritis hand?

    No. The honest goal is a comfortable, useful hand - not the hand you had at twenty. Trapeziectomy reliably relieves pain but pinch strength is slightly less than pre-arthritis.

  • Will I need a splint after surgery, and for how long?

    Yes. Almost every hand arthritis operation involves a custom splint or plaster - for two weeks (some PIP fusions) up to six weeks (CMC and wrist fusions). Your therapist fits it before you leave the ward.

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