AT BEL AIR CENTER FOR PLASTIC AND HAND
Arthritis is a degenerative joint disease that affects your joint’s cartilage. Arthritis of the hand accounts for roughly eight percent of all osteoarthritis cases. Two-thirds of those with rheumatoid arthritis have wrist and hand problems. Arthritis causes can include: genetics, previous injury, physically demanding motion, infection or allergies, obesity or autoimmune disease. Serious cases of arthritis may need surgery to restore both appearance and motion.
The more common type of arthritis, osteoarthritis, is a degenerative bone disease that slowly wears away the cushioning cartilage that allows joints to glide easily when they move. As the cartilage is worn away by arthritis, the smooth surface becomes rougher. This causes joint movement to become uncomfortable. Eventually, the cartilage may wear away completely, leaving bone to rub directly on bone.
Without the protective cartilage, joint movement becomes very painful. The increased friction during movement causes inflammation, which increases joint pain. Since each hand contains 29 major joints, patients with osteoarthritis in their hands feel near-constant pain during simple daily tasks.
Like osteoarthritis, rheumatoid arthritis (often called RA) causes joint pain and limits movement. However, rheumatoid arthritis is actually an autoimmune disorder. Instead of degrading the cartilage, the immune system attacks the synovial lining within the joints. This lining promotes smooth, gliding movement. As the synovial tissue becomes inflamed and swollen, the joint is stretched and displaced. The end result is inflammation and painful joint motion.
Rheumatoid arthritis often affects joints on both sides of the body, and is commonly seen in the hands. RA can be diagnosed by a combination of patient-reported symptoms and nodules below the skin. A blood test is also taken to look for rheumatoid factors. Severe cases of rheumatoid arthritis can cause joint deformity as the synovial tissues swell. RA can also contribute to the development of carpal tunnel syndrome.
Surgical Arthritis Treatment
A variety of treatments are available to treat both osteoarthritis and RA. Most patients find relief with over-the-counter NSAIDs like ibuprofen. Preventative approaches like supplements and hand therapy can also help. For patients with RA, special medications can be used to limit the overreaction of the immune system. However, since arthritis is degenerative, treatments may become less effective over time. In most arthritis patients, the disease progresses and worsens.
Arthritis surgery performed by our Bel Air Center plastic surgeons can repair or replace the affected joint(s). There are different options for treatment depending on your needs.
Joint Fusion is recommended for severe bone deterioration. During surgery, your surgeon will remove the arthritic surface. At the same time, he or she will permanently join the bones on either side of the joint. This prevents further movement that would make symptoms worse.
Joint Reconstruction allows joints to move after surgery. During joint reconstruction, the affected area of the joint is removed. Soft tissue from elsewhere in the patient’s body is used to rebuild the joint. Sometimes an artificial joint may be used for replacement.
Recovery and Results
Recovery following surgical arthritis treatment happens in stages. At first, patients will need to wear a special splint that limits motion in the hand and wrist. Patients can work up to more activity. Including hand therapy as part of recovery is important to help resume full function. The ultimate goal of surgical arthritis treatment is to restore as much movement as possible while reducing pain.