Hand Surgery for Rheumatoid Arthritis.

Edited By: Thomas Trumble, M.D.
Last updated Thursday, October 14, 2004

About the procedure

Technical details

Three major classifications that are performed and these can be performed in different sites.

1. Synovectomy is removal of the diseased tissue. This is most commonly done at the level of the wrist and sometimes is accompanied by the removal of portions of bones that have been destroyed by the disease. Occasionally these surgeries to remove the diseased tissue are combined with surgeries to transfer tendons if tendons have already ruptured. A tendon that duplicates another tendon function is removed and physically moved to attach to the end of the tendon that has ruptured. The ruptures cannot be repaired in an end-to-end fashion because the disease destroys a segment of the tendon.
2. Replacements are done by removal of the disease joint surfaces that are producing the pain and interposing an artificial joint that is usually made of a soft synthetic material. These joints typically have a stem on either end with a spacer in the middle. The stems are placed in the ends of the bone on either side of the joint that has been removed.
3. Joint fusions mean removing the joint and stimulating the bones to grow across the site of the joint surface to create a solid segment of bone. This is usually done by adding bone graft material with bone from another site of the body such as the pelvis or wrist and using metal plates or pins to stabilize the bones while the fusion takes place.

Anesthetic

Length of hand surgery

Surgery for arthritis of the hand at the University of Washington

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