Synovectomy, Tendon Sheath, Radical (Tenosynovectomy), Flexor Tendon, Palm and or Finger, each Tendon

The surgical treatments for Rheumatoid Arthritis (RA) of the hand and wrist include synovectomy, tenosynovectomy, tendon realignment, reconstructive surgery or arthroplasty, and arthrodesis. Appropriately timed surgical intervention helps alleviate pain, improve function, retard progression of the disease, and improve appearance. Consequently, independence is greater and self-image is improved.

Surgical treatment is much more likely to be successful if it is implemented early in the course of the deformity. If the patient does not receive timely referral to a hand surgeon, the resultant function of the hand may be severely compromised. When a patient with rheumatoid arthritis (RA) develops joint deformities in the hand or wrist that are unresponsive to medical management, surgical intervention is often necessary. These deformities lead to loss of the ability to grip, grasp, and pinch, often leaving the patient unable to perform the activities of daily living

Preoperative

Your health care provider will talk to you about how to prepare for surgery. You may be told not to eat or drink anything after midnight on the day of your surgery. You will be told what medications to take or not take on the day of your surgery before surgery; you will need to obtain clearance from your regular doctor if you have medical problems. You may be required to obtain some basic tests for screening before the surgery. Basic blood tests, a chest x-ray, and an EKG may be required depending on your health.

Surgical Procedure

Synovectomy, Tendon Sheath, Radical (Tenosynovectomy), Flexor Tendon, Palm and or Finger, each Tendon the treatment of these specific deformities depends on the severity of disease in each involved joint. Fixed joint deformities with bony destruction are usually more amenable to fusion than arthroplasty. However, in general, in an attempt to preserve motion, fusion of 2 joints in tandem is considered the last-stage effort. IP joint fusion is tolerated extremely well and maintains function. Tenosynovectomy excision or resection of a tendon sheath.

Recovery

Within three months, restoration and pain is diminished. Most normal activities can resume in about six months and even earlier for some patients. Strength recovery takes 3-6 months and improves depending upon the amount of weakness prior to surgery and the intensity of the strengthening exercises during rehab.

Risk

As with any surgical procedure, complications can occur, some possible complications may include, but are not limited to the following:

• Infection
• Damage to nerves, tendons or cartilage
• Stiffness or loss of joint motion
• Tumor, Mass may reappear, though this is uncommon

Stiffness can be addressed post-surgery with rehabilitation