Question:Years ago, my grandmother had one of the first finger joint replacements for her rheumatoid arthritis. As my mother remembers it, the implant didn't work and she ended up having the finger fused. Now that I've also been diagnosed with RA, I'm wondering what's in store for me. Do they still do finger joint replacements when things get really bad?
Answer:Treatment of rheumatoid arthritis (RA) has improved quite a bit since your grandmother's time. New medications called disease-modifying antirheumatic drugs (DMARDs) have made a big difference.
DMARDs is a category of drugs used in many autoimmune disorders. They slow down disease progression (how fast and how much the joints are damaged). Joint replacements are an option for some patients. Usually pain is the deciding factor.
Patients with low demand are the best candidates for joint replacement. Results with joint implants do not provide the strength and motion needed by manual laborers, for example. Long-term studies show that the benefits of pain relief and improved motion do not always last beyond 10 years.
Your physician will be able to guide you in making any future decisions about treatment. Many RA patients are able to manage very well with medications and an exercise program. By managing the disease early, long-term complications with the need for joint replacements can be avoided.Taruna J. Madhav, MD, and Peter J. Stern. Current Opinions in Orthopaedics: Advances in Joint Replacement in the Hand and Wrist. In Current Opinion in Orthopaedics. July 2007. Vol. 18. No. 4. Pp. 352-357.
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