Hand & Wrist
If conservative treatments are not providing pain relief or arthritis-based deformities are limiting the use of the hand, surgery will often be considered. Hand surgery can restore function, relieve pain and improve the appearance of the hands for patients suffering from arthritis. Hand surgery is usually performed under general anesthesia or local anesthesia with sedation, on an outpatient basis. The surgeon will make an incision to access the targeted area. Many hand procedures can be performed laparoscopically, allowing patients to benefit from smaller incisions, less bleeding and shorter recovery times.
Depending on the type of arthritis and the extent of the damage, injured tissue may be removed from the joint, tendons and ligaments are repositioned, or the entire joint is replaced with a prosthetic.
After hand surgery, patients may experience mild to severe pain. Your doctor will provide you with oral medication to manage pain, if needed. The hands will usually need to be immobilized for a few days as they heal. Patients usually require a course of physical therapy in order to restore full function and range of motion to the hand.
Total Wrist Replacement
The wrist joint is not a common target of full replacement, but instances of serious degeneration due to arthritis may indicate this course of action. The goal of the procedure is to eliminate the severe pain associated with these problems and restore lost strength and stability to the joint so the patient may perform normal activities free of pain and other symptoms.
The cartilage deteriorating between the carpal bones, radius and ulna is the source of the pain that is to be fixed. The ideal patient for a total wrist replacement has severe arthritis but does not need to use their wrist for demanding tasks. While joint replacement will reduce pain and restore strength, the new joint will not be as strong as a natural joint. In patients with severe arthritis in both wrists, it is usually recommended to replace one wrist and have the other fused, so that one has good range of motion while the other is strong for stressful tasks.
The new joint itself is a ball-and-socket made of metal and plastic. The socket fits into the radial head while the ball is attached to the carpal and metacarpal marrow cavities. This procedure requires that several carpal bones and the radius head be removed from the wrist entirely while the new joint is drilled and fitted. Most patients experience long-term pain relief from this procedure and do not require additional treatment.