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Arthroplasty (joint replacement) and arthrodesis (surgical fusion) are commonly used techniques for the treatment of severe joint conditions within the hand, including arthritis and other degenerative conditions. Surgery is often considered a last resort treatment to relieve pain, stiffness and swelling and restore function to the affected joint. Your doctor will determine which procedure is best for you based on a thorough evaluation of your condition.
Arthroplasty involves replacing the damaged joint with an artificial one, made of metal or plastic, which is held in place with bone cement and provides long-term symptom relief. Arthrodesis involves fusing the bones of the affected joint together to manage pain and restore function to the joint. Both of these procedures can be performed through arthroscopic techniques for added benefits.
Arthroscopy is a minimally invasive procedure that allows doctors to diagnose and sometimes treat joint injuries and disease through small incisions in the skin. During an arthroscopic procedure, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the problem area, allowing the doctor to examine the joint in great detail.
For some patients it is then possible to treat the problem using this approach or with a combination of arthroscopic and “open” surgery. Sports injuries are often repairable with arthroscopy. Tendon tears in the knee are frequently repaired in this way. Other potentially treatable injuries include torn cartilage or ligaments, inflamed joint lining, carpal tunnel syndrome, rotator cuff tears, and loose bone or cartilage.
Arthritis causes swelling and inflammation in certain joints as a result of damage to the protective cartilage in the area, causing pain and stiffness. Bursitis is a common condition that involves inflammation of a bursa, the fluid-filled sacs that help to cushion the bones, which leads to pain, stiffness and swelling in the affected joint. These conditions may be caused by overuse, stress or trauma to the joint.
Treatment for these conditions may include anti-inflammatory medications, cortisone injections or surgery, such as joint replacement, for more severe cases. Although these conditions cannot be cured, treatment is often effective in relieving symptoms and allowing patients to return to a more desirable level of functioning.
Joint aspiration, also known as arthrocentesis, is a minor surgical procedure that involves draining fluid from a joint with a sterile needle and syringe. This may be performed for either diagnostic or treatment purposes in patients with swelling, inflammation and pain within the hand and wrist.
Aspiration of these joints is usually performed under local anesthesia and involves inserting a needle with a syringe attached to it into the affected area. Fluid within the joint is sucked (aspirated) into the syringe and then sent to a laboratory for complete testing.
Carpometacarpal (CMC) and thumb arthritis is a painful, chronic condition that can seriously affect your everyday life and prevent you from performing simple tasks. The CMC joint is the joint that connects the wrist to the base of your thumb. Combined with the function of your thumb, these joints play an important role in nearly every movement of the hand. CMC and thumb arthritis cause pain, swelling, stiffness and tenderness throughout the wrist and hand.
Since arthritis is a chronic condition, treatment focuses on reducing pain and other symptoms to keep the disease from interfering with everyday life. A combination of treatments is often most effective and may include splints, medication or injection. Surgery may be required for patients that do not respond to conservative treatments.
Congenital deformities of the hand are physical deformities present at birth that can significantly affect a child's hand function and appearance. Deformities may occur as a result of abnormal development, birth injuries or genetic factors, and can involve fingers that are fused together (syndactyly), an underdeveloped hand (clubhand), extra fingers (polydactyly) and other abnormalities.
Surgical treatment for congenital deformities varies depending on the type and severity of the deformity, but may include tendon transfers, skin grafts, limb manipulation, external appliances or prosthetic devices to restore normal function and appearance to the hand. Physical therapy is often needed as well to ensure proper development of hand function in young children.
Similar to carpal tunnel syndrome, cubital tunnel syndrome causes pain and numbness as a result of long-term nerve inflammation. In cubital tunnel syndrome, the ulnar nerve is affected at the site of the cubital tunnel, located in the elbow. Inflammation may occur as a result of frequent bending of the elbow or simply from the natural anatomy of the elbow joint.
Treatment for cubital tunnel syndrome may involve anti-inflammatory medication, splints, braces or life changes to relieve symptoms or prevent them from occurring. For symptoms that do not respond to conservative methods, surgery may be needed to relieve pressure on the ulnar nerve, which can be done through ulnar nerve transposition or medial epicondylectomy. Most patients are able to receive successful relief from cubital tunnel syndrome.