Rheumatoid Arthritis and Atypical Arthritidies-Current Concepts in the Management of the Rheumatoid Hand

Current Concepts in the Management of the Rheumatoid Hand

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Hand surgeons play an important role in the management of patients with rheumatoid arthritis (RA). While medical treatments for RA have improved, surgery can still offer patients hope for improving hand function and appearance. New studies have highlighted the differences between hand surgeons and rheumatologists in their treatment approaches. Advances in medical treatments, such as biologic medications, have decreased the prevalence of hand deformities caused by RA. However, these medications can be expensive and may not always be used in all healthcare systems. <br /> <br />Rheumatoid arthritis affects a significant portion of the population and can cause hand and wrist dysfunction in over 70% of patients. While the incidence of RA hand problems is decreasing in the US due to more effective medications, many patients who do not respond to medical treatment are not being referred for hand surgery consultation. Rheumatologists are divided on the effectiveness of surgery for RA hand deformities, with some believing that it is not particularly effective. However, hand surgeons argue that surgery can offer significant improvement in hand function and appearance for patients with RA. <br /> <br />The current state of rheumatoid hand surgery involves minimizing inconsistencies in surgical care for these patients, particularly in the choice of surgical procedures. Research on outcomes plays a crucial role in assessing the effectiveness of different surgical procedures and their impact on patients' quality of life. Current surgical treatment strategies include wrist arthrodesis or arthroplasty, MCP joint arthroplasty, extensor tendon reconstruction, and correction of swan-neck and boutonniere deformities. <br /> <br />Collaboration between hand surgeons and rheumatologists is essential in the overall management of patients with RA. Treatment plans should be individualized based on the patient's needs and expectations, as well as considerations of the underlying disease. Further research is needed to improve surgical outcomes and guide appropriate management of the RA population.

Keywords

Hand surgeons

Rheumatoid arthritis

Medical treatments

Surgery

Hand function

Hand deformities

Biologic medications

Healthcare systems

Wrist dysfunction

Surgical procedures