Rheumatoid and inflammatory arthritis
Some types of arthritis cause the body’s immune system to attack its own joint cartilage, ligaments, and even the bone itself. When this happens a rheumatologist is usually asked to see the patient and immunosuppression medicines are recommended. However, after many years living with rheumatoid or other inflammatory arthropathies, the joints can become painful and often deviate to the side. Sometimes tendons can rupture as a result.
Mr Wharton works as part of a multi-disciplinary team with rheumatologists and hand therapists to determine the best treatment for this sort of hand problem. Often patients have remarkably good function of their hands, despite the altered appearance. If that is the case then surgery may not be necessary at all.
When patients experience flares of pain that won’t settle with anti-inflammatory medicines, Mr Wharton offers synovectomy surgery to remove some of the inflammatory tissue. If tendons rupture as a result of the arthritis Mr Wharton offers tendon transfer surgery, to use spare tendons and move their insertion to allow them to help restore the function that has been lost. For joints that are badly damaged Mr Wharton offers joint replacement or joint fusion surgeries. The joint replacements stop the worn out bone ends from knocking against each other, and allow movement, but can only reliably achieve the movement that patients already have in that particular joint. Sometimes the joint is so stiff from arthritis that it doesn’t move much anymore. Under those circumstance Mr Wharton also offers joint fusion (arthrodesis) surgery where the worn out cartilage is removed and the bone ends are held with metalwork so that new bone grows across the joint. If the joint doesn’t move it often doesn’t cause pain, and so this treatment can be very effective at improving hand pain.