New trend of Hand surgery in RA patients

Abstract

(Introduction) It has been reported that biologic agents suppress the progression of the joint destruction in rheumatoid arthritis (RA). For this reason, joint replacement surgery for large joints has been reported to decrease, but small joint surgeries have been reported to increase on the other hand. The purpose of this article is to review the new trend of RA hand surgery.
(Wrist joint surgery) In this new era, synovectomy (including of arthroscopic synovectomy) is important especially for patients of early stage RA wrist joint when the involved joint does not favourably respond to conservative treatment. For the joint destructive case, arthroplasty (with Sauvé-Kapandji procedure, for example) or joint fusion might be selected. Recovery of Function and range of motion will be essential for new trend of RA wrist surgery.
(Finger joint surgery) Finger joint synovectomy have been recommended to perform for early stage which is before any deformities are observed. In this stage, joint conserving surgery will be essential. Operation for RA hand deformities have to be indicated according as needs of patients. Pursuing both functional recovery and cosmetic improvement is the new trend. We have to announce that severe RA hand deformity can be improved. There are expectaions for improvement of artificial finger joints in the future. Meticulous rehabilitation and bracing will be required than ever as postoperative care.
(Conclusion) New trend of RA hand surgery has been reviewed. More progress will be observed in this field, and so RA hand surgery is important and will be expected to become advanced in future.