Hand Surgery for Rheumatoid Arthritis.
Edited By: Thomas Trumble, M.D.
Last updated Thursday, October 14, 2004
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Figure 1 - Post-operative plaster splint Recovering from surgeryPain and pain management The amount that patients have can be related to the severity of
their deformity prior to surgery. Most patients can manage these
surgeries on an outpatient basis but some patients need to stay in the
hospital over night to receive stronger pain medication.
Most patients with rheumatoid arthritis only take the medication for
two to three day after the surgery. For some of the larger joint
replacement surgery or when multiple joints are involved, the patients
will need to stay over night and have intravenous pain medicines
administered. When only one or two joints are involved, the patient can
be managed on an outpatient basis with oral medication.
Medication typically relieves pain but can cause drowsiness. Because
of the drowsiness caused by these medications, it is recommended that
the patient does not drive a car or operate machinery while taking pain
medication. Hospital stay In the hospital, the patients typically have intravenous fluids so they
do not become dehydrated and they receive pain medications that are
adjusted to their pain level. In come cases, therapy is begun but in
most cases therapy is delayed until the swelling subsides, which takes
one to two weeks.Recovery and rehabilitation in the hospital Rehabilitation is typically delayed until the patient is evaluated in
the office one to two weeks after the surgery. The recoveries vary
tremendous depending on the type of surgery performed and what
combinations of surgery are required.Hospital discharge Most patients are discharged with a plaster splint that limits their
motion (see figure 1). For most patients, elevation of the hand is
important to decrease the swelling. When the patient is discharged,
they should have oral pain medication that is successful in relieving
symptoms as well as having appointments for their office follow-up. It
is important that the patient has a plan for where they would like to
have the therapy for their outpatient therapy, as this is usually an
essential part of the patient's rehabilitation.Convalescent assistance We would typically recommend therapy for joint replacements, joint
fusions, or synovectomies over a course of approximately six weeks
following the surgery. The patients can nearly always be discharged to
their home and they do not require a convalescent facility. Because the
patients have limited hand function, assistance with cooking and
cleaning for the first three to four weeks after the surgery is advised.Surgery for arthritis of the hand at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-BONE (2663) to make an appointment. Our clinical center is located in Seattle Washington, USA
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