The author reviews the pathophysiological mechanisms of rheumatoid deformations of the long fingers' MP joint. He considers the different possibilities of surgical treatments; then focusing on arthroplasty, he compares and comments on technical points (incision, resection of the MP head, section of intrinsic muscles, size of the implant, joint capsule and ligament reconstruction, dressing, postoperative care) and results (mobility, implant fracture, ulnar deviation and palmar dislocation) achieved by various authors. He concludes that the Swanson implant remains at present the best therapeutic treatment of rheumatoid arthritis of the long fingers' MP joint. However, in order to improve the results obtained, and to avoid long term complications, research should be pushed until we can avail ourselves of a true prosthetic arthroplasty based on other principles and new materials.