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Low-cost procedure for deformity correction in rheumatoid hands.

Pawan Agarwal¹, Raju Vaishya², Dhananjaya Sharma³

¹Professor and In Charge Plastic Surgery Unit, Department of Surgery, NSCB Government Medical College, Jabalpur, India.

Scottish Medical Journal

|October 26, 2020

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Low-cost dorsal capsule interpositional arthroplasty effectively corrects ulnar drift in rheumatoid arthritis patients. This procedure improves hand function and reduces pain, offering a viable alternative to expensive silicon joint implants.

Area of Science:

Orthopedic Surgery
Rheumatology
Hand Surgery

Background:

Rheumatoid arthritis (RA) commonly causes ulnar drift of the metacarpophalangeal joint (MPJ).
Conventional treatment involves silicon joint arthroplasty, which is costly and prone to complications.
Autologous interpositional arthroplasty presents a low-cost alternative.

Purpose of the Study:

To evaluate the efficacy of dorsal capsule interpositional arthroplasty for correcting ulnar drift in RA patients.
To assess functional recovery and pain alleviation following the procedure.

Main Methods:

Five patients (8 hands, 32 MPJs) underwent dorsal capsule interpositional arthroplasty.
Outcomes were measured by MPJ movement recovery and ulnar drift correction.

Keywords:

Rheumatoid arthritis dorsal capsule frugal innovation hand deformity interpositional arthroplasty joint destruction low cost option synovitis

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Functional improvement was graded (excellent, good, fair), and pain was assessed using a Visual Analogue Scale (VAS).

Main Results:

Excellent results were achieved in 3 patients (20 arthroplasties), good in 1 (8 arthroplasties), and fair in 1 (4 arthroplasties).
Mean VAS pain score decreased from 8.2/10 preoperatively to 1/10 postoperatively.
At an average follow-up of 1.4 years, patients reported good hand function, pain relief, and no recurrence of deformities.

Conclusions:

Dorsal capsule interpositional arthroplasty is a cost-effective surgical option for correcting post-RA ulnar drift.
The procedure significantly improves hand function and cosmesis.
It effectively avoids complications associated with silicon joint arthroplasty.