Joint Replacement Surgery Of The Hand (cont.)
What are the different surgical options?
Surgical options include
- cleaning of the abnormal cartilage and bone, including removal of bone
spurs,
- fusion of the joint, and
- joint replacement surgery.
The optimal surgical treatment of arthritis of the hand and wrist
varies from patient to patient and is based on many factors. These
factors include the patient's age, hand dominance, employment, level
of pain, functional goals, and underlying disease.
When is surgical cleaning of the joint the best alternative?
Surgical cleaning of the joint, or salvage procedure, is usually
performed in cases of early "wear and tear" arthritis where there are
painful bone spurs or, in cases of rheumatoid arthritis, where there
is a large amount of inflamed tissue. Removal of bone spurs is
especially helpful when the arthritis involves the joints at the ends
of the fingers (distal interphalangeal or DIP joints).
What is a joint fusion? When is it the best surgical
option?
Fusion of a joint involves removing the joint and
surgically "fusing" the bone ends so that the two bones effectively
become one solid bone. This procedure terminates all motion at that
joint and thus eliminates the pain. The benefit of fusion is pain
relief and the downside is elimination of motion at the fused joint,
which can hinder function. This surgical option is reserved for
patients with advanced arthritis.
Joint fusion is usually the best surgical option in patients who
are younger and very active. Younger patients may not be candidates
for joint replacement because of the increased stress demand on the
joints which accompany higher activity levels. This increased stress
demand can quickly wear out an artificial joint.
When is joint replacement surgery the best surgical option?
Joint replacement surgery in the hand is an excellent option for
treating arthritis of the hand in older, low-activity patients and
for those with rheumatoid arthritis. Joint replacement surgery can
provide pain relief, increase finger range of motion, and improve
hand function.
Next: How do the surgical options vary with the different joints of the hands and wrists? »
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