What is the role of hand and wrist surgery in the treatment of rheumatoid arthritis (RA)?

Updated: Jan 11, 2019
  • Author: Michael Neumeister, MD, FRCSC, FACS; Chief Editor: Joseph A Molnar, MD, PhD, FACS  more...
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Answer

Answer

The surgical treatments for RA of the hand and wrist include synovectomy, tenosynovectomy, tendon realignment, reconstructive surgery or arthroplasty, and arthrodesis. [4] Surgical treatment is much more likely to be successful if it is implemented early in the course of the deformity. If the patient does not receive timely referral to a hand surgeon, the resultant function of the hand may be severely compromised.

A study by Ishikawa et al on the systemic effects of rheumatoid arthritis (RA)–related orthopedic surgery found significant improvement in physical function and reduction in disease activity, at 6 and 12 months postoperatively. Of the study’s 276 patients, 74 (26.8%) underwent surgery to the wrist, and 63 (22.8%) underwent surgery to the hand. [5]


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