For several years, Debbie Brickell endured worsening arthritis in one of her fingers, a condition that not only affected her daily life but also threatened her ability to work. Eventually, a finger joint replacement at The Horder Centre offered her a solution.
What started as a mild, dull ache gradually worsened, with her finger becoming increasingly painful, knobbly, and swollen, making even the simplest tasks unbearable.
Debbie, a healthcare receptionist, said: “Daily tasks like peeling potatoes or opening jars were unbearable. Even holding my grandchildren’s hands became too painful, and I would often have to pull away.
“My GP referred me to an Advanced Practitioner for a steroid injection to provide pain relief, but it was not enough to make a significant difference. Even simple tasks like writing appointment cards at work became agonising. Over time, I reached a point where I was genuinely concerned about my ability to keep doing my job.”
Debbie was referred to The Horder Centre, where she saw Mr Oliver Harley, a Consultant Plastic Surgeon who specialises in hand and wrist surgery, and he explained that a finger joint replacement would be the best solution.
Several months later, Debbie arrived early in the morning at The McIndoe Centre in East Grinstead, the sister site of The Horder Centre, for her Proximal Interphalangeal Joint (PIP) replacement, a procedure that involves removing the damaged finger joint and replacing it with an artificial joint.
She said: “I was nervous about the procedure, but on the day, I felt surprisingly calm. I walked down to the theatre where I had a pain block in my arm. I have Type 1 diabetes and was carefully monitored throughout the operation. The team chatted with me, music was playing, and the environment was as relaxed as possible. At one point, they even asked if I wanted to look at my finger during the procedure, which I wanted to do as it was an opportunity I would not get again.”
The surgery itself took around 45 minutes, and afterwards, Debbie was back in her room, where she received some lunch and was monitored before being discharged by the mid afternoon.
Debbie’s hand was bandaged and in a sling to keep it elevated. She took four weeks off work to rest and heal, easing back with a phased return once the stitches were removed. It is important to use the finger as much as possible to improve flexibility, so during Debbie’s recovery, she had physiotherapy every two weeks at The Horder Centre, which was vital for regaining movement.
She added, “The healing was long. At my follow-up appointment, Mr Harley was very pleased with my progress and explained that it can take up to a year to fully recover.
“The swelling gradually subsided and the scar is barely visible now. The increased range of flexibility and reduced pain are the biggest improvements for me. Occasionally, if I overuse the finger, it gets a bit red, but the difference this surgery has made is remarkable. I can now type, garden, and even hold my grandchildren’s hands again without flinching.
“The team were amazing—polite, attentive, and professional. My experience was better than I could have expected, and I wouldn’t hesitate to recommend the procedure to anyone suffering from similar issues. If I ever needed another joint replacement, I’d do it without hesitation.”
Debbie Brickell
Mr Harley said: “Finger joint replacements are well established and they have been available for 40 years or more. However, it seems to be the case that there is little awareness among the public or even among family doctors that it is possible to treat joint arthritis in this way.
“Each finger has three joints; any of these can be affected by arthritis and any of the joints in the fingers can potentially be treated with finger-joint-replacement if pain becomes severe and troublesome. Some patients will simply have a single joint that is really bad for them and others find that many of the joints are unfortunately affected.
“Typically, we would initially try to treat arthritic finger joints by injecting steroid into the joint, which is easily done in an outpatient clinic. For patients who fail to respond to this treatment, finger joint replacement may be appropriate. The operation is an awake day case operation. Although the fingers will be bandaged, patients can commence with gentle household activities straight after surgery and they are also encouraged to do exercises from an early stage by our expert hand therapists. It takes several months for the finger to settle and recover and for the final results to be realised."
“Debbie has been a very positive and lovely patient, and I am so pleased to have been able to help her be more comfortable and to have better use of her hand as a result. We use a patient assessment questionnaire to assess the outcomes of hand surgery - prior to her finger joint replacement she rated her finger pain as “extreme” and she gave an overall score of 48% hand-disability on account of arthritis; six months after surgery, she was only rating her pain as "mild" and with only a 5% hand-disability score. This has obviously been a dramatic and helpful change for her. "
Mr Oliver Harley, Consultant Plastic Surgeon
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The Horder Centre is an award-winning Centre of Excellence that offers patients a unique therapeutic environment. Specifically designed for orthopaedic surgery, our facilities include a physiotherapy inpatient gym and courtyard gardens designed by clinical experts to enhance recovery. Finance options available.
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