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Carol Eustice

Rheumatoid Arthritis Patients With Hand Deformity Benefit from Surgery

By June 4, 2009

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Hand deformity is one of the most common complications associated with rheumatoid arthritis. Replacement of the knuckle joints with solid silicone joints is a surgical treatment option. Over the years, there has been disagreement between hand surgeons and rheumatologists regarding who should have the surgery, when they should have it, and the expected outcome. A new study published in the June 2009 issue of Plastic and Reconstructive Surgery, the medical journal of the American Society of Plastic Surgeons, concludes that hand surgeons believe surgery is beneficial to both early and late stage patients -- but that severe deformities are more difficult to completely correct.

This report was of particular interest to me. In the mid-1970s, I was diagnosed with rheumatoid arthritis and had a hip double-cup arthroplasty at age 25. My fingers were starting to become bent, some had even contracted. My hip surgeon, pleased with the outcome of my hip surgery, referred me to a hand surgeon because he felt I should have the knuckle replacement surgery. The hand surgeons took x-rays and performed range of motion tests and function tests. He declined to do the surgery, saying, he didn't do it for cosmetic reasons -- only to improve function and reduce pain. Mine weren't painful and they were still surprisingly strong. Before all was said and done, I was referred three times to plastic or hand surgeons and turned down each time.

Fast forward to 2009, surgeons and medical doctors are seeing that it doesn't necessarily pay to wait. According to the Arthritis Foundation, 1.3 million Americans have rheumatoid arthritis. More than 8,000 hand surgeries were performed in 2008 due to complications from arthritis. Discuss hand surgery with your doctor and an orthopedic surgeon so you can weigh benefits and risks associated with the surgery.

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