Osteoarthritis (OA) of the hand is a slowly progressive articular disorder. It happens late in life and principally affects load-transmitting joints. Further forms of inflammatory arthritis include rheumatoid arthritis, gouty arthritis, psoriatic arthritis, among other rarer forms of arthritis.
Arthritis symptoms include pain, stiffness, difficulty in moving as well as swelling of the joints. In late cases, symptoms also include deformities.
Most arthritic conditions can be managed non-operatively with non-steroidal anti-inflammatory drugs, patient education and reassurance, hand therapy, splintage, activity modification and occasionally steroid injections.
In more serious cases where patients experience persistent pain and are unresponsive to non-operative treatment, or suffer deformity, instability or stiffness that impairs function, a joint reconstructive surgery would be required.
Joints can be reconstructed by various means. These include fusions and various forms of arthroplasties such as:
Rheumatologists are the best specialists to manage these conditions. However, in cases where medication cannot control the pain or when the joint is completely destroyed, reconstructive surgery may be required; and this is when hand surgeons play an important role.
The joints that are commonly affected by osteoarthritis of the hands include:
Treatment of arthritis of these joints include rest, splinting and medications. As mentioned, in severe cases when conservative measures fail, surgery may be required.
This comes in the form of:
The following are examples of joint replacement for severe arthritis of the hand and wrist:
Pre-operation basal joint arthritis with pain and deformity
Joint replacement with Electra
Osteoarthritis of the middle finger presenting with pain swelling and stiffness
X-ray showing osteoarthritis of the PIPJ with loss of joint space
Proximal interphalangeal joint (PIPJ) replacement
Ulnar head replacement for osteoarthritis of the distal radial ulnar joint
Total wrist joint replacement
Elbow joint replacement
Are you experiencing symptoms of arthritis related to the upper limb? Speak to our hand care team to find our if this is the medical condition you have at +65 6733 9093. Or book an appointment with our hand specialists for a consultation on your symptoms and treatment options.
Figure A: Pre-operative deviation of the fingers due to joint destruction
Figure B: 4 artificial joint transfer and radiological picture of the joint transfer
Figure C: Joint reconstruction: Figure showing an artificial joint transfer to the left middle finger