The joint pain, swelling, and stiffness that accompanies rheumatoid arthritis (RA) can make everyday activities feel like a chore. Approximately 1.5 million people in the U.S. have this chronic autoimmune condition that can cause bone erosion and joint deformities in the hands and wrists. Left untreated, RA can impair normal function of the knees, ankles, elbows, hips, and shoulders, as well.
RA tends to worsen over time and can lead to inability to grip, grasp, and pinch with the hands and fingers. While there is no known cure for RA, medication can reduce symptoms, improve function, and minimize damage to the joints. However, when drugs alone are not enough, plastic surgery can be an effective – if unexpected – treatment option. Along with treating symptoms, plastic surgery can slow the progress of RA and restore the look and appearance of the hands.
Which plastic surgeries can improve RA?
1. Arthroplasty (joint replacement surgery)
This is an advanced procedure in which the damaged parts of the finger joints are replaced with silicone prosthetic joints to restore normal function and movement to the fingers while also straightening them and improving their appearance. Multiple fingers can be treated in the same session.
In this minimally invasive procedure, we remove bone and cartilage fragments that cause inflammation in the joints. The procedure uses small incisions in the fingers, and pain during recovery is usually minimal.
If a joint cannot be replaced, arthrodesis might be an option. This is a fusion surgery in which the joints are attached and stabilized to restore proper alignment and function.
In this procedure, we remove inflamed tissue in the synovium, or the lining of the joints in the fingers, wrists, elbows, knees, and hips. Synovectomy can help prevent tendon rupture and improve tendon mobility in patients who are diagnosed with early-stage RA.
5. Tendon release surgery
This procedure splits or disconnects ligaments affected by RA to reduce pain and restore movement and function.
6. Tendon transfer surgery
This procedure rebalances the wrists and fingers to reduce pain and restore function. A working tendon is removed from one side of the wrist and attached to the tendon of the damaged muscle. Depending on the severity of the damage, more than one tendon transfer can be accomplished in a single procedure. In some patients, repair can be done without the need to transfer tendons.
What to expect after plastic surgery for RA
Most surgical procedures for rheumatoid arthritis use minimally invasive techniques so patients have less scarring and shorter recovery times, usually ranging from two to four weeks. While some surgical procedures require a hospital stay, most can be done on an outpatient basis.
Physical therapy and rehabilitation might be necessary to improve patients’ hand or joint function and help them regain strength and flexibility. At UT Southwestern, we take a team approach to RA plastic surgery. Our patients have access to rheumatologists, plastic surgeons who specialize in RA procedures, physical therapists, and occupational therapists. Our collaborative approach, combined with the latest treatments, gives our patients the most comprehensive care at any stage of RA.