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If the prescribed non-operative treatment options fail to provide relief, then surgery is generally considered. There are a variety of surgical options. The option chosen should be one that has a good chance of providing long-term pain relief and a return to good function. Unlike knee and hip replacements, joint replacements in the wrist and hand made out of metal and plastic are not always good answers for the treatment of the arthritic hand. The more reliable procedures are those in which bones are removed or fused. While limiting some mobility, these procedures have great outcomes in relieving pain and restoring function. This procedure replaces a diseased or damaged finger joint with an implant made of silicone rubber or hard metal, ceramic or pyrocarbon. This procedure can be used to replace the middle joint of the finger (called the PIP joint) or the joint at the base of the finger (called the MCP joint).