Arthritis of the hand
Arthritis of the Hand
Arthritis causes damage to the normal cartilage that covers the ends of bones where joints are formed. There are two broad types of arthritis.
1. Osteoarthritis, more commonly known as wear and tear arthritis. This is caused by use of the joint or sometimes by an injury. The cartilage initially splits and becomes rough and thin. Later on it wears through completely and the bone ends rub together. This may be felt as a grating sensation. The finger and thumb joints are commonly affected with this type of arthritis.
2. Inflammatory arthritis, an example of this is rheumatoid arthritis. The body’s own immune system damages the joints and surrounding tissues including ligaments and tendons. There is typically more swelling and stiffness in the mornings with an inflammatory arthritis
What are the symptoms?
Here are the treatments available for arthritis of the hand:
Steroid Injection – can be useful in selected cases and may give several weeks/months relief of symptoms. One or occasionally two injections are advised because of the risk of cartilage damage with further injections.
Joint Fusion – this involves stiffening or fusion the joint in the position of maximal function. It is a good way of improving pain but does eliminate all movement in the fused joint. The fusion is normally performed with wires, screws and sometimes plates. The hand functions surprisingly well provided the surrounding joints are functioning.
Joint Replacement – this can be performed in very selected cases where both movement and pain relief are required and the patient is prepared to accept the limitations and risk associated with joint replacement surgery. Most of the joints in the hand can be replaced with a variety of joint replacements available including silicone (plastic), pyrocarbon ( similar to ceramic), metal and plastic ( similar to knee replacements). Certain types of joint replacements are more suitable to inflammatory (rheumatoid) arthritis.
The decision making around joint replacements and soft tissue reconstructions in the hand is complicated and many factors have to be taken into account. These will all be discussed with you at your consultation. You may also need a Hand Therapy assessment to identify specific functional deficits and to discuss the post-surgery rehabilitation.