When rheumatoid arthritis of the hands causes severe deformities and impairs daily function, surgery may provide a solution. Dr. Leonard Gordon at Hand and Microsurgery Medical Group, is an orthopaedic hand specialist who treats rheumatoid arthritis of the hands and wrists; serving patients in San Francisco, California.
Specialists in Rheumatoid Arthritis
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease in which cells of the body mistakenly attack itself. In the case of rheumatoid arthritis, the attack centers on the joints – although many other organ systems can also be affected. Rheumatoid arthritis causes inflammation to the tissue lining the joints, and this inflammation ultimately damages the joint cartilage. This damage cannot be reversed.Research shows that 90% of the people diagnosed with Rheumatoid Arthritis lose complete mobility of their hand within 10 years, if they don’t seek immediate treatment.
Why does Rheumatoid Arthritis set in?
The immune system is designed to produce antibodies to protect the body during illness. When bacteria, virus and other aggressive disease-causing agents enter the body, the antibodies attack and destroy them.
But for people with a faulty immune system, antibodies are produced even when there are no health problems. These antibodies then attack the cells of the bodies and destroy the body from the inside.
Rheumatoid arthritis is one such autoimmune disease. The immune system gets confused about the possibility of a bone/joint condition and it releases antibodies that start attacking the cells and the lining of the joints. This attack weakens the joints and causes extensive damage.
What are the symptoms?
Women are more likely to develop rheumatoid arthritis than men, and the disease usually begins between the ages of 30 and 60. Rheumatoid arthritis often affects the hands, and usually affects both hands, as well as other joints like wrists, elbows, knees, and hips. Symptoms include joint pain, swelling and in some cases, heat or redness. The joint gradually becomes less mobile and may also become deformed.
Treatment Options for Arthritis
Treatment of rheumatoid arthritis is directed toward relieving pain and inflammation and preventing the progression of the disease. Very significant advances have been made in the medical treatment, and these medications have made surgery much less common for this problem. These medications do carry side effects and should be taken under the direction of a knowledgeable medical specialist. People with rheumatoid arthritis may have periods of few symptoms (remission), or an acute attack (flare). Exercise is important to maintain mobility and flexibility of the joints, but it must be balanced with rest. Splints may also be used to slow the progression of deformities.
When is surgery necessary?
Since the joint damage of rheumatoid arthritis is progressive, it may eventually damage joints to the point where the function is severely compromised. Surgical options include synovectomy (removing the abnormal lining of the joint), tendon repair for ruptures, joint fusion, and joint replacement.
Surgical Options
Synovectomy
The synovium is a soft tissue membrane that lines the joints, tendon sheaths, and bursae. In a synovectomy, the doctors will remove the synovium to prevent damage to the cartilage and bone.
Carpal tunnel release
Carpal tunnel damage is common when diagnosed with rheumatoid arthritis. The carpal tunnel release surgery is performed to release the pressure on the carpal tunnel passage and alleviate pain.
Surgery for Tendon and Joint Damage
Joint fusion surgery
Rheumatoid arthritis can cause joints to weaken and drift apart. This causes immense pain and discomfort. Our doctors will perform a joint fusion or bone fusion surgery, which will help reduce the pain and swelling in the joints.
Tendon repair and realignment
Aggressive rheumatoid arthritis can damage the tendons in the hand and wrist, making the hand very unstable and weak. Tendon repair and realignment surgery can restore strength and stability to the hand.
If you’d like to schedule a consultation with Dr. Joshua Gordon, MD or Dr. Leonard Gordon, MD, feel free to contact us today.
