Rheumatoid arthritis

Hand surgery

Rheumatoid arthritis (RA) is a systemic disease which can affect any part of the body, and may be associated with other disorders such as psoriasis or systemic lupus. RA is a chronic inflammation of the synovial joint membrane and tendon sheath, in the form of a proliferative synovitis which causes an extension of the joint capsule, tendon dislocation, as well as infiltration into and erosion of the bone. The infiltration of tendons or their friction as they slide over the bony spurs may even cause their rupture. The surgical treatment of RA of the hand aims at pain control, prevention of disease progression, correction of deformities, reconstruction of the damaged structures, as well as improvement of appearance and motility. Surgical management of RA comprises various surgical procedures on the dorsal surface of the radiocarpal joint, the flexor tendons, as well as on the metacarpophalangeal and proximal interphalangeal joints. The joint procedures include synovectomy, ligament reconstruction, as well as arthroplasty and arthrodesis; the soft-tissue procedures comprise tenosynovectomy, tendon reconstruction, resection of the rheumatoid nodules, and nerve decompression.