Rheumatoid Arthritis: Rozental TD

Chacko AT, Rozental TD. · Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215, USA. · Hand Clin. · Pubmed #18675723 No free full text.

Abstract: Rheumatoid arthritis of the thumb is a common source of disability. Obtaining an understanding of the underlying biologic and physical manifestations of rheumatoid arthritis is essential in the choice of treatment of the disease. In the early stages of the disease, conservative and less invasive measures can be used. In the more advanced stages, arthrodesis and arthroplasty are often used. Isolated interphalangeal involvement is best managed with arthrodesis. Metacarpophalangeal involvement in low-demand patients can be treated with arthroplasty, whereas arthrodesis can be used in more active patients. Patients who have carpometacarpal joint damage are best treated with trapezium resection arthroplasty.

Rozental TD. · Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. · J Am Acad Orthop Surg. · Pubmed #17277258 No free full text.

Abstract: Thumb deformities are common manifestations of rheumatoid arthritis and represent a significant source of disability. A clear understanding of the pathophysiology of the disease is essential in directing treatment. Differential diagnosis for flexible deformities includes soft-tissue imbalances as well as tendon ruptures. In its early stages, thumb involvement can be treated nonsurgically or with soft-tissue reconstruction. With more advanced disease, arthrodesis and arthroplasty often are required. Isolated interphalangeal involvement is best addressed with arthrodesis. Metacarpophalangeal involvement can be treated with arthroplasty in low-demand patients or with arthrodesis in more active patients. Trapezium resection arthroplasty provides excellent relief for patients with carpometacarpal joint destruction.