There are many beneficial surgical procedures that can be used in the management of patients with arthritis of the hand. Often these can complement the medical management of arthritis by rheumatologists. It is suggested that patients discuss the role of hand surgery in the treatment of their arthritis with their rheumatologist or contact hand surgeon Dr. Richard Hamilton directly to determine if hand surgery may be of benefit.
Hand surgery can restore movement in the thumb and fingers, ease painful swelling and inflammation, and also remove deformities of bone and/or tissue.
There are several hand surgery procedures used to treat rheumatoid arthritis and osteoarthritis. Surgery is usually recommended after the disease process is established, but it can also have a role in prevention of disease progression by surgical removal of the diseased tissue (synovectomy) when medical treatments have been ineffective. Surgery for joint pain can involve joint fusion (arthrodesis) or joint replacement with natural tissues or artificial joints (arthroplasty).
Plastic surgery of the hand can also be beneficial in improving the deformities of the hand caused by the arthritic process, resulting not only in a more natural hand appearance, but also improved hand function.
Following arthritis hand surgery, there may need to be a period of hand rehabilitation to achieve the best functional result. This therapy is usually supervised by a qualified hand therapist who works with Dr. Hamilton, and may involve splinting to protect the surgery during healing, and then mobilisation to optimise hand function.
It is important to understand that neither medical nor surgical treatment can cure arthritis; however hand surgery can certainly improve hand function to minimise disability and prevent much of the pain involved with this condition.
The two common forms of arthritis affecting the hand are osteoarthritis (a degenerative joint disease), and rheumatoid arthritis. Both conditions are progressive and can be painful and debilitating.
This procedure is the surgical excision of inflamed, painful arthritic soft tissues around the wrist, finger joints and tendons. It is of benefit to patients who have failed to respond to medical treatment or who may be concerned about side effects of medication. It is effective in quickly alleviating the symptoms caused by painful swollen wrist arthritis and for synovitis of the finger and wrist tendons.
The basal joint of the thumb is commonly affected by osteoarthritis causing collapse, deformity, pain and stiffness in the joint. In more advanced arthritis the trapezium bone and adjacent bones can collapse causing a painful deformity. In this situation only surgery can relieve the pain and reconstruct the thumb joint to restore grip function. Although implants have been used for this joint reconstruction, Dr Hamilton favours a tendon arthroplasty procedure (Weilby Arthroplasty), which reconstructs and stabilizes the joint with a wrist tendon after removal of a small Trapezium bone. Surgery is undertaken as a day case at Hamilton House under general anaesthesia, and recovery takes 4-6 weeks before return to normal hand function.
Please note that the information about procedures here is given as a general guide, and is not a substitute for an in depth, personal consultation with Dr. Hamilton. As with any surgery there are risks and complications to consider, all of which will be clearly communicated to you during your one on one consultation with Dr. Hamilton.
