The development of functional hand reconstruction led to the introduction of silicone implants for small-joint arthroplasty in the 1960s. Swanson pioneered silicone implants for metacarpophalangeal and proximal interphalangeal joint reconstruction, which subsequently became widely used, particularly for patients with rheumatoid arthritis.

However, post-traumatic and degenerative arthritis often involves one or two joints and presents different functional demands, creating a need for alternative implant designs. This led to the development of cemented and cementless fixation techniques, with increasing emphasis on osteointegration and improved implant stability.

Several designs have subsequently been introduced to improve longevity, stability, pain relief, and range of motion, including surface-replacement implants and pyrocarbon prostheses. Pyrocarbon technology has also been applied to finger and carpal joint arthroplasty. In addition, numerous prosthetic designs have been developed for the trapeziometacarpal joint to address hand osteoarthritis.

The presentation reviewed the evolution of small-joint arthroplasty, advances in implant design and materials, fixation techniques, clinical outcomes, and contemporary approaches to hand joint replacement.

Lucia Heras-Garcia Qualified in Madrid (Universidad Complutense) in 1980. Trained in major University hospitals in Madrid and London. Specialized in Trauma and Orthopaedic Surgery in Spain, followed her main interest in Hand surgery and further her training in this specialty in Spain, London, and Kentucky. She was the Lead Consultant of the Hand Unit which she developed for 13 years in London (Newham University Hospital), developing her Unit and training a large number of junior doctors, She has published a number of papers in hand pathology and trauma, and has been an invited speaker in numerous local, European and International Congresses, been also co-author of a book edited in Spain, where was invited to write some of the chapters. She is a member of the British Society for the Surgery of the Hand (BSSH), Spanish Society for Surgery of the Hand (SECMA), European Society for Surgery of the Hand (FSSH), British Orthopaedic Association (BOA), Spanish Society of Cosmetic Medicine and Surgery, and British Medical Association (BMA). Always involved in teaching. She has been an invited visiting Professor in a number of Courses in Hand Surgery. She was a Faculty member in the 2-year fellowship training program in Hand Surgery running in the Gaza Strip for 6 years. Examiner for the GMC (PLAB) and for London University for 10 years. She has also worked for the GMC (General Medical Council) for 5 years as an Assessor for Fitness in Orthopaedics.