Several small joints in your hand work together allowing you to do different things. When these joints are affected by arthritis, you are likely to experience pain, deformity, and disability of the hands. Hand surgery for arthritis is not very common though, and is restricted to two procedures called arthrodesis and arthroplasty.
Board certified plastic surgeon Dr. Bram Kaufman provides hand surgery to patients in Cleveland, Beachwood, Pepper Pike, Lyndhurst, OH, and surrounding communities.
What is Arthrodesis?
Arthrodesis is a procedure in which the joint bones are fused together to create a knuckle that is more stable and free of pain. However, such a knuckle loses its flexibility and range of movement.
What is Arthroplasty?
This is a type of knuckle surgery in which the damaged joint is entirely removed and replaced by an artificial implant which restores the shape and function of the knuckle and also gives pain relief. However, finger flexibility is less than that of natural fingers.
Which Procedure is Right for You?
Your doctor will choose either arthrodesis or arthroplasty depending on the degree of repair your fingers require. Your age, physical activity level, and ability to tolerate stiffness of the joint are also critical factors considered when deciding which form of surgery is best for you. Sometimes, your surgeon may recommend both procedures for different knuckle joints in the same hand.
Types of Hand Surgeries Used in Arthritis
The specific hand surgery technique to be used in hand arthritis will vary based on the position of the affected joint.
The knuckles at the finger base, also called metacarpophalangeal (MCP) joints, are the most critical for motion and flexibility of your fingers. When these joints are damaged by rheumatoid arthritis, your doctor will generally recommend arthroplasty to replace the joint and eliminate the pain. Mobility of the joint may be restored to some extent depending on how much healthy soft tissue is present in the area.
Base of the Hand Joints
Also called proximal interphalangeal (PIP) joints, these are the joints in second position from the base of your hand. They are most likely to be affected by osteoarthritis that results in stiffness and loss of movement. When this condition affects the middle and ring fingers that play an essential role in gripping, the surgeon may recommend replacement surgery. Some surgeons may prefer to fuse the PIP joints because they are capable of tolerating stiffness better than the other joints.
Finger End Joints
When arthritis affects the distal interphalangeal (DIP) joints, or the joints at the ends of the fingers, surgeons recommend the use of arthrodesis. This procedure can render the joint pain-free, stable, and reasonably functional.
This is a procedure in common use for more than 40 years to treat thumb arthritis. In LRTI, the surgeon removes the joint surfaces that are damaged and replaces them with a tissue cushion to keep the bones separate. This surgery requires a complete or partial removal of the wrist’s trapezium bone at the thumb base.
Plastic surgeon Dr. Bram Kaufman receives patients from Cleveland, Beachwood, Pepper Pike, Lyndhurst, OH, and nearby areas for hand surgery.
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