Rheumatoid Arthritis, or RA, is agonizing. For those who suffer from this degenerative illness of the joints of the hand, life can quickly become a nightmare of pain and eventual deformity as the disease worsens. However, one variety of the disease, metacarpophalangeal joint disease, can be successfully treated by means of plastic surgery.

By replacing diseased knuckle joints with artificial joints manufactured from silicone, doctors can now restore function to the hands and dramatically reduce pain for rheumatoid arthritis patients.

But the procedure is not without controversy. Some rheumatologists – physicians who specialize in the treatment of joint diseases – disagree with hand surgeons over when such replacements should be used.

Rheumatologists involved in the disputes think it’s better to wait until the later stages of RA to do a joint replacement; hand surgeons believe in earlier intervention. Both groups agree that surgical treatment is good for the patient at any time – but when is the best time?

A new study – the largest of its kind to date – says that sooner is better. The study looked at the outcomes of 70 RA patients who had been through joint replacement surgery.

These patients were separated into two groups: one group whose joint replacement operations took place during the early stages of the disease, and one group who received the implants to replace advanced deformities of the disease’s later stages.

The results of each patient’s replacement surgery were examined six months later and again one, two, and three years after surgery.

The exams showed that both groups of patients benefitted from surgery: their hand deformities had become less severe over three years. However, the group of patients who had received the surgery during the advanced phase of the disease still had significant deformities.

Doctors determined that the more severe the deformity at the time of replacement, the more difficult it is to fix.

Although the study supports the view that earlier surgery is better, doctors from both specialties agree that a team approach to surgical treatment of RA is best.

Click the screen below to catch this week’s Plastic Surgery News!

Organizations in the Episode:

• Merz Aesthetics
• American Society for Aesthetic Plastic Surgery
• Dr. Corey Maas, MD, FACS
• Plastic and Reconstructive Surgery (medical journal)
• Dr. Scott Oishi, MD, FACS
• John Woo (director)
• Brigham and Women’s Hospital
• Dr. Bohdan Pomahac, MD
• MyFreeImplants.com
• Melissa Joan Hart