Arthritis treatment, Geelong

Plastic surgery for arthritis, Geelong

An x-ray shows the damage of arthritis in a hand.

What types of arthritis are there?

  • Osteoarthritis from wear and tear is the most common
  • Other types include inflammatory forms such as rheumatoid arthritis and arthritis associated with conditions such as psoriasis.

What are the symptoms?

  • Pain
  • Stiffness
  • Swelling
  • Deformity

What can be done?

  • Splints – can support the joint and help control pain. They may help prevent further deformity or deviation.
  • Steroid injection – aimed at reducing inflammation in the joint and controlling pain. The benefits may last six months or more, however the injections do not alter the course of the disease. It is not recommended to have more than two or three injections in a 12-month period.
  • Surgery – an option when splints or steroid injections no longer control pain. The surgery may involve stiffening the joint (arthrodesis) or replacing the joint. Splints and hand therapy are usually required after surgery.

Surgery for arthritis in specific joints

1. Interphalangeal arthritis

This arthritis affects the small joints in the fingers.

Arthrodesis (stiffening the joint)

  • Will reduce the pain in the joint at the expense of movement
  • May improve the function of the hand by reducing pain and providing stability.
  • Useful especially for the very end joints (distal interphalangeal joints) and occasionally the joint second from the end (proximal interphalangeal joints).
  • Usually performed under local anaesthetic and sedation or general anaesthetic as a day case in hospital.
  • Involves trimming back the bone in the joint and fixing the bones with pins and wires.
  • Pins are usually removed at six weeks.
  • A splint is worn after surgery to support the healing bone. Hand therapy is required to keep other joints in the hand moving and to help control swelling.
  • Complications, though unusual, may include infection, bleeding, failure of the bone to heal.
  • Recovery and return to work make take between eight to 12 weeks.

Joint replacement

  • Will reduce pain and possibly preserve or improve movement
  • Best suited to the joint second from the end of the finger (proximal interphalangeal joint).
  • Usually performed under local anaesthetic and sedation or general anaesthetic as a day case in hospital.
  • Involves inserting a artificial joint made of titanium and plastic components.
  • Hand therapy is required after joint replacement to ensure the best range of movement is obtained.
  • Recovery and return to work may take between eight to 12 weeks.
  • Complications include infection (including that of the artificial joint), bleeding, stiffness, failure/fatigue of the joint.
  • The joint will not last forever though if not loaded excessively or repeatedly will function for as long as 10 to 15 years.

2. Basal arthritis of the thumb

  • Indicated when pain can no longer be controlled by splints or steroid injections.
  • X-rays/scans will help determine the most appropriate type of operation.
  • For those with mild x-ray changes, an osteotomy to change the alignment of the bone and alter the wear pattern in the joint can be suitable. Sometimes part of the joint can be removed. These operations are designed to preserve the joint as much as possible. Further operations might be required in the future if the arthritis progresses.
  • Moderate to severe arthritis requires removal of the bone at the base of the thumb (trapeziectomy). Sometimes this is all that is done. Often a tendon is taken from the wrist to support the base of the thumb and the unused part of the tendon is used to fill the space where the bone has been taken away (suspension arthroplasty). This operation is aimed to reduce pain, although the thumb may shorten and pinch strength maybe reduced.
  • Surgery is usually performed under general anaesthetic as a day case.
  • A splint is worn for six weeks post surgery. Hand therapy will be required especially after the splint is removed. The period of rehabilitation is approximately 12 weeks.
  • Complications are uncommon though may include infection, bleeding, injury to nerves, complex regional pain syndrome (a rare condition following hand surgery or injury involving pain, stiffness and swelling).
  • Surgery is aimed at reducing pain. This can take up to six months to resolve after surgery. Pain may persist, particularly if there is arthritis in other joints.

The first step to diagnosing your condition and determining the best treatment plan is an initial consultation with Mr McDonald. During this session, you will be invited to ask all your questions to ensure you are happy and comfortable, and we will discuss the procedure itself and the care you will receive during and afterwards.

Mr Anthony McDonald also performs other medical plastic surgery including treatment for carpal tunnel syndrome, Dupuytren’s disease and trigger finger.