I have had two of my finger joints replaced due to rheumatoid arthritis. One is a ceramic implant. The other is silicone. They both seem to work fine. I heard there's an even better implant now available that's made of carbon. Should I have that kind in my next finger joint replacement?

You may be referring to a new biomedical material called pyrolytic carbon or pyrocarbon. Implants coated with this substance reduce the risk of blood clots called thrombosis. Blood clots do not form easily on the surface of this material. The FDA has approved pyrocarbon implants for use in the hand to replace joints.

Early reports from the use of this implant have been favorable. Long-term results aren't available yet. The majority of patients report improved motion with an 80 per cent decrease in pain. Pinch and grip strength improved but not always significantly.

In a small number of patients, problems develop requiring additional surgery. Deformity, contracture, dislocation, loosening, and fracture are potential complications.

Your surgeon is the best one to advise you on implant type and material. Not all surgeons are using pyrocarbon implants. Not all patients are good candidates for the surgery or for this implant.