Arthritis of the Hand

Arthritis of the Hand surgery in Montreal

The base of your thumb, your knuckles, second joint and top joint of our fingers are common sites for hand arthritis. Osteoarthritis, rheumatoid arthritis and psoriatic arthritis are common types.

What is arthritis of the hand?

Arthritis is a disease that attacks the tissues of your joints. A joint is where two bones meet. Arthritis can attack the lining of your joint or the cartilage, the smooth covering at the ends of bones. Eventually the cartilage breaks down, the ends of your bones become exposed, rub against each other and wear away. You have many joints in your hand, therefore it’s a common site for arthritis to happen.

Arthritis of the hand causes pain and swelling, stiffness and deformity. As arthritis progresses, you can’t use your hands to manage everyday tasks as you once could.

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    Types of arthritis in the hand

    Fingertip Joint Arthritis

    • About 10% of people develop hereditary arthritis in the joints of the fingertips, also called the distal interphalangeal joints.
    • Putting pressure on our fingertips it’s similar to the amount of pressure we put through our knees when we’re walking. Because of this, its common to get patients with little nubby bumps on their fingers, called Heberden’s nodes, which are actually small bone outgrowths. These bumps rarely need to be treated unless it is impacting their mobility.

    Basal Thumb Arthritis

    • Nearly 25% of women over the age of 50 develop arthritis in the thumb. That figure jumps to more than 50% for women over the age of 70. Because men seldom suffer from thumb arthritis, we believe that the ligaments that hold the joint together have estrogen receptors in women. After 50, when women lose their estrogen throughout menopause, the ligaments stretch out and the joint degenerates.

    Post-Traumatic Arthritis

    • Post-traumatic arthritis is a form of osteoarthritis that occurs after a joint injury, but because arthritis develops gradually, it is hard to pinpoint when the condition began.
    • For example. we see a lot of arthritis in the wrist due to undiagnosed fractures, particularly a scaphoid or undiagnosed ligament injury. With injuries like this, it is hard to recognize arthritis early because it can take 8 to 10 years or more before we identify it, which is why it’s common at ages 45 to 60.

    The wrist is prone to arthritis because there are no muscle or tendon attachments to the eight bones in the wrist, which means there isn’t much protection from everyday wear and tear.

    Causes

    The exact cause of hand arthritis is unknown. The condition usually develops due to wear and tear of the joint, which occurs gradually over time.

    There’s also a genetic component to hand Osteoarthritis (OA). Family members may develop Osteoarthritis at a younger age than the general population, and may have more severe disease.

    A healthy joint has cartilage at the end of the bone that cushions and allows smooth movement. In Osteoarthritis, cartilage deteriorates, exposing the underlying bone, which triggers joint pain and stiffness.

    Symptoms

    Symptoms differ slightly depending on the type of arthritis you have, but these differences can help us determine the correct underlying cause. Common symptoms include:

    • Pain in the hands and fingers
    • Swelling in your hand/wrist joints
    • Stiffness in your joints and hands
    • Weakness in your hands

    Symptoms are present more often

    • Pain may change from dull ache to sharp pain.
    • Pain may wake you up at night.
    • Pain may cause you to change the way you use your hand(s).
    • Tissue surrounding your affected joint may become red and tender to the touch.
    • You’ll feel grating, grinding, cracking or clicking (crepitus) when bending your fingers.
    • Your fingers can’t fully open and close.
    • Your finger joints become large and deformed and abnormally bent, leaving your hands weak and less able to accomplish everyday tasks.

    Diagnosing Arthritis in Hands

    Diagnosing hand arthritis involves an evaluation and tests. Your doctor will check the joints in your hand for signs of OA.

    Signs include:

    • hand joint tenderness
    • swelling
    • deformity
    • limited range of motion

    In some cases, your doctor will also order an X-ray to look for cartilage loss and other signs of damage. This can indicate arthritis of the hand and that they should look for potential bone spurs and erosions.

    Symptoms of hand Osteoarthritis can be similar to other joint conditions. Your doctor may also order blood tests, especially to exclude other types of arthritis like rheumatoid arthritis.

    Treatment for Arthritis in Hands

    If nonsurgical treatments no longer provide relief and the cartilage at the ends of your bones has worn away, surgery may be an option. Surgical treatment for hand arthritis includes fusing the bones on the sides of the arthritic joint together, or reconstructing the joints.

    There are several approaches:

    Joint fusion (arthrodesis): This surgery uses a plate and screws to keep the bones of your joint together. You’ll have a more stable, pain-free joint, but will have limited flexibility and movement.

    Joint replacement (arthroplasty): Similar to other joint replacements, surgeons use an artificial implant made of plastic, ceramics, silicone or metals to replace your damaged joint. Keep in mind that hinged finger implants don’t mimic normal finger movement.

    Tendon transfer: Tendons connect muscles to bones. The tendons that control your fingers attach to muscles in your palm and forearm. Ongoing inflammation from arthritis can cause tendons to rupture. If this happens, a portion of a healthy tendon can be used to restore your hand function.

    You and your surgeon will discuss which surgical approach might be best for your hand considering your age, activity level, the joint(s) affected and the amount of pain and deformity you’re experiencing.

       

      What should I expect after hand surgery?

      You may need a cast or splint after surgery to protect your hand while it’s healing. Your surgeon may refer you to a hand therapist. Your provider will likely prescribe pain medication to take for a limited amount of time to reduce discomfort.

      It is our goal at Station L to ensure that your entire experience from the initial consultation to your recovery is as positive and comfortable as possible. Your plastic surgeon and surgical coordinator will go over your post-operative instructions and recovery with you as it is essential for your Hand surgery results that you follow care instructions closely.

      • Keep your dressings clean and dry: until your doctor says otherwise. If you need to bathe or shower, cover the dressings with a plastic bag taped securely at the opening to prevent getting wet, and keep the area out of the direct stream of water. If your dressing becomes wet, call your doctor immediately. DO NOT remove or modify the dressing unless instructed by your doctor.
      • Elevate your arm and hand: To prevent and minimize swelling and pain, raise the hand/arm above the level of the heart for 3-5 days. When indicated, you will be given a sling or blue Carter pillow. The hand may be held down only for brief periods of time. Continue to elevate the hand if swelling or pain persists after 3-5 days. Move your unaffected joints on the surgical side as much as possible to help with swelling and prevent stiffness. For example, if you had surgery on your thumb, then move your shoulder, elbow, wrist and other fingers.

      Part of our process at Station L is making sure that you have all the information you need to make informed decisions and feel guided through the entire process. Our concept is for you to have a five star experience, and our goal is for you to have the best possible outcomes and least possible complications.Proper follow-up care is key for a successful recovery. Be sure to go to all your follow-up appointments as directed and call the office if you have any issues or questions.

      Our office is always available for questions via email or text message should more questions arise.

         

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        Nancy Simard

        Nov. 02, 2022

        Excellent follow-up from the two Dr. Izadpanah (Arash and Ali). In addition, the administrative staff as well as the nurses are very efficient and patient-oriented. Congratulations to the whole team for the impeccable approach and care.

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        Amélie L.

        July 2022

        A great surgeon who listens. You quickly gain confidence in his frankness and expertise. The results obtained are beyond my expectations and I am definitely grateful. A crush for Dr. Arash, for Nashrine, for Marie-Ève and Noémie the nurses who accompanied my process and for the nice ladies at the reception.

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        July 2022

        A great surgeon who listens to his patients and above all who does a remarkable job. For me it is a big crush that I will not hesitate to recommend to anyone in need of surgery. I will go back to see him for sure!.

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        Emy-Lhi L.

        June 2022

        What a great team and Dr. Arash is an exceptional, reassuring and talented surgeon. A beautiful human. Nashrin, thank you for supporting us in the process with gentleness, good listening and understanding. A lot of empathy in this team.

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        Anonymous patient

        January 2022

        Very good surgeon. I had a mommy makeover (abdominoplasty and breast lift with implant) by Dr. Arash and I am very satisfied. He's a magician. I can't stop staring at my chest.

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