Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by a T cell-driven autoimmune process, which majorly involves the diarthrodial joints. It affects 1% of the US population, and approximately 70% of patients with RA develop pathologies of the hand, especially of the metacarpophalangeal joints (MCP). Furthermore, also the extensor and flexor tendons of the fingers are frequently involved. The first line of treatment should be conservative. Three general classes of drugs are currently available for RA: nonsteroidal anti-inflammatory agents (NSAIDs), corticosteroids, and disease modifying antirheumatic drugs (DMARDs). Encouraging results have been obtained using DMARDs. However, when severe deformities occur or when patients are unresponsive to medical management and injections therapy, surgical intervention should be performed to relieve pain and restore function. Several surgical options have been described for the management of MCP joint deformities, including soft tissue procedures, arthrodesis, and prosthetic replacement. Tendons ruptures are generally managed with tendon transfer surgery, while different surgical procedures are available to treat fingers deformities. The aim of the present review is to report the current knowledge in the management of MCP joint deformities, as well as tendons damage and fingers deformities, in patients with RA.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by a T cell-driven autoimmune process, which majorly affects the diarthrodial joints
The aim of the present review is to report the current knowledge in the management of metacarpophalangeal joints (MCP) joint deformities, as well as tendons damage and fingers deformities, in patients with RA
The aim of this paper is to report the current concepts in the surgical management of rheumatoid hand
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by a T cell-driven autoimmune process, which majorly affects the diarthrodial joints. Multiple adverse side-effects ranging from mild irritability to severe and life-threatening cardiovascular events and adrenal insufficiency are associated with the prolonged use of corticosteroids [6]. Both NSAIDs and corticosteroids are not able to change the disease course or help to improve radiographic outcomes. Biologic agents can be divided into two subgroups: tumor necrosis factor (TNF) inhibitors and interleukin-1 receptor antagonists [8] Both classes of drugs reduce the cytokines’ activity modulating the inflammatory process that underlies RA pathogenesis, and encouraging results in terms of radiographic progression and function have been reported in the literature [9]. The aim of this paper is to report the current concepts in the surgical management of rheumatoid hand
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
