“Patients are happy right off the bat,” says Arnold-Peter Weiss, M.D., a hand surgeon, professor of orthopedics, and associate dean of medicine at Brown University Medical School, in Providence, R.I. “It even surprises me.”

The procedure is quick and relatively straightforward, but it’s not appropriate for everybody and does carry a risk of complications and failure. Moreover, some experts argue that knuckle replacements have not been studied thoroughly enough to justify their widespread use in arthritis patients. Still, it’s a viable option for people in severe pain.

Is knuckle replacement right for you?

Knuckle replacements have been around since the 1950s. In general, the surgery is used only in people with severe pain or lack of mobility. That typically means arthritis patients whose pain interferes with daily activities and people whose pain isn’t alleviated by nonsurgical treatments like finger braces, splints, or anti-inflammatory medications such as Advil or Aleve.

Historically, knuckle replacement was most common in patients with rheumatoid arthritis (which can cause hand deformities), although the procedure is pretty evenly split now between RA and osteoarthritis patients, says Jay Bridgeman, M.D., assistant professor of hand and microvascular surgery at the Penn State College of Medicine. Improvements in rheumatoid arthritis medications over the years have reduced the number of surgeries that are necessary, he explains.

The purpose of the surgery is to remove the damaged cartilage, tissue, and bone, and insert an artificial replacement joint in the remaining healthy bone. Although the new joint doesn’t entirely restore mobility, it can almost completely eliminate pain and return the hands to their normal shape.

Dr. Weiss, who practices at Rhode Island Hospital, says he performs anywhere from one to three knuckle-replacement surgeries each month, usually on the knuckles at the base of the fingers (known as the metacarpophalangeal joints). Osteoarthritis patients typically get one or two of these joints done at once, while rheumatoid arthritis patients often have all four of them “go bad” at the same time, he says.

Nortin Hadler, M.D., a rheumatologist and professor of medicine at the University of North Carolina at Chapel Hill, says he doesn’t recommend the procedure to as many patients as he once did. “Now rheumatologists are more aggressive at treating the diseases — because we can be,” he says. “The medications are better and the disease is milder — partly because of earlier diagnosis — and we are less enthusiastic about the surgery.”

The effectiveness of knuckle replacement is a matter of ongoing debate among hand surgeons and rheumatologists. Surgeons, not surprisingly, are more likely to believe it’s a worthwhile procedure. In a 2003 survey, 83 percent of hand surgeons said that knuckle replacement “always” or “usually” improves hand function, compared with just 34 percent of rheumatologists. Likewise, 92 percent of surgeons and 60 percent of rheumatologists replied that the surgery always or usually relieves pain.

What are the options?

Depending on the joint that needs to be repaired and the finger in which it is located, there are various options for treatment. These include a total knuckle replacement, fusing the existing joint together (known as arthrodesis), or cleaning away damaged cartilage and bone.

The small knuckles at the tip of the finger aren’t usually replaced, as studies have shown that failure and poor longevity can be a problem with this joint. Fusion is typically effective at relieving pain in these knuckles, though it does not restore mobility, Dr. Bridgeman says.

By contrast, the middle knuckles are usually replaced, particularly those on the ring and middle finger, which need to retain flexibility for gripping. (The exception is the middle knuckle on the index finger. Fusion is generally preferred because this joint gets heavy use and prosthetic s tend to wear out too quickly.)

The bottom knuckles, where the fingers meet the hand, are the largest and are almost always replaced, especially in rheumatoid arthritis patients.

Several types of replacement knuckles exist. The most widely used versions — including a model patented by Dr. Weiss — are made from flexible silicone rubber and act like spacers between the remaining healthy bones. Although these implants allow flexibility, they tend to break and slip.

To avoid these complications, researchers are trying to make better metal-and-plastic replacement joints that work like a ball-and-socket — like most prosthetic knees and hips — so they fit in the joint more tightly.

Regardless of which knuckle is being replaced or what device is used, the surgery is a quick outpatient procedure. Each knuckle takes about 30 minutes, Dr. Weiss estimates. The procedure is covered by Medicare, which reimburses doctors about $600 per joint, although the full cost of the procedure may vary widely.

Recovery time

The procedure carries a small possibility of complications. As with any surgery, there is a slight risk of infection, and cases of enlarged lymph nodes (lymphadenopathy) have been reported.

In most cases, patients typically feel about 90 percent better almost immediately, Dr. Weiss says. But Dr. Hadler says that the recovery is neither simple nor brief.

After surgery, patients are required to undergo physical therapy, which can last anywhere from six to 12 weeks. Rheumatoid arthritis patients tend to need more rehab than those with osteoarthritis, because they usually also have to work on problems in their shoulders and elbows, Dr. Weiss says.

During that time they gradually regain their strength and mobility. Patients are in a splint for the first few weeks, and after that they wear the splint only at night and use the hand normally during the day.

The surgery is very effective at reducing pain, Dr. Bridgeman says, but most patients lose range of motion in the joint over time.

There is also a small risk of damage to the implant. Up to 30 percent of replacement knuckles break, although some studies have found higher rates of fracture.

If that doesn’t happen, knuckle implants — like artificial knees — tend to break down after about 10 to 15 years, at which point the finger begins to feel unstable and wobbly, Dr. Weiss says. Five to 10 years after surgery, some patients experience stiffness, joint breakage or dislocation, and recurrent pain.

The number of people potentially needing knuckle replacement surgery could rise in the coming years as more Baby Boomers are afflicted with osteoarthritis — a disease that occurs as we age. But Dr. Hadler says he and other doctors would be wise to help patients improve their joints and work around problems in lieu of having surgery.

“The goal is make it so our patients don’t need the surgery in the first place,” he says. “I would rather we have them use large pens and get different doorknobs [that are easier to grip] than have surgery.”

There are millions of people worldwide who suffer from arthritis. Arthritis is an inflammation of the body’s joints. Any part of the body can be affected. The symptoms can vary from mild pain and stiffness to severe debilitating pain, where the sufferer has lost mobility to some degree.

There are two main types of arthritis, osteo-arthritis and rheumatoid arthritis. Osteo arthritis is the most common type and the main symptoms are pain and stiffness. Rest can be of great benefit to this type of arthritis and most of the symptoms can be alleviated this way. Rheumatoid arthritis is an inflammatory disease that can affect people of all ages. The main symptom is painful stiff joints that become swollen and often deformed. Often suffers of rheumatoid arthritis can become depressed and their quality of life can be severely curtailed.

As of yet there is no known medicine to cure this disease. There are many drugs on the market to help with the symptoms and can give relief for a varied length of time. But the question has to be asked does this medicine cause another problem? Lengthy courses of cortisone based medicine are often prescribed to patients suffering from rheumatoid arthritis. While initially an improvement can be felt, long-term the benefits are just not achieved. As these medicines contain so many chemicals and compounds one wonders how many side effects there are.

Doctors prescribe medicines on a daily basis knowing that what they are prescribing will not cure the problem but it will reduce the severity of the inflammation.

Gold injections are widely used with patients suffering from rheumatoid arthritis. This is a chemical compound containing gold. The doctor prescribing this knows it will not cure the arthritis but that it will reduce the severity of the symptoms. In a few hours after administration the patient will be feeling better and more active. This is a welcome relief from arthritis pain.

Aspirin remains the best reliever of symptoms which has the fewest side effects. Having said this long-term use can still cause unwanted side effects such as ulcers in the stomach to mention just one. As medicines are advancing all the time it is only a matter of time before these side effects will be lessened.

Corrective surgery is also a thing to be considered. This is always an option when the patient’s joints become swollen and deformed. Surgery is a difficult choice to make for any patient as there is a very long recovery afterwards. As always with surgery it can carry its own risks with a patient who is not mobile or in good general health. Joint replacement can have excellent results and mobility can be restored to the joint eventually. Offering new possibilities to the arthritis sufferer.

Definite Foods For Treating Arthritis

WHEN TREATING ARTHRITIS THERE ARE DEFINITE FOODS TO AVOID AND SPECIFIC FOODS TO EAT.
You need to make sure that the calcium to phosphorus ratio in any of the foods you eat is as low as possible – this is because excess phosphorus will increase the loss of calcium from the body and worsen the condition. The more phosphorous-containing foods you eat, the more you need to supplement with a good source of calcium.

Reduce your intake of:

1. red meat, red-fleshed fish

2. most grains, especially wheat.

Eliminate:

1. soft drinks – high in phosphoric acid

2. organ meat (liver, kidney), processed meat – especially high in phosphorus

3. caffeine – increases the rate of loss of minerals and nutrients

4. fried foods and vegetable oil – a high intake of fried foods and omega 6 from vegetable oil can make the inflammation worse

5. sugar – results in poor absorption of nutrients

6. antacids – neutralize stomach acid and result in poor absorption of calcium (heartburn and indigestion are caused by poor eating habits and NOT ENOUGH stomach acid!)

Important Note: Eliminate the bad fats such as margarine, cooking with too much vegetable oil and fried foods from your diet. A high intake of vegetable oil (a source of Omega 6) needs to be avoided as this will aggravate any inflammation.

Treating Arthritis Foods

The best treating arthritis foods are diets high in calcium and magnesium and other trace minerals – this will ensure healthy bone and bone matrix structure. Specific nutrients are also required to build bone and bone structure.

Calcium: Non fat milk, yogurt, cottage cheese, snow peas, soybeans, tofu, sardines, salmon, walnuts and almonds, sunflower seeds, kale and other green leafy vegetables, broccoli, alfalfa seeds – to name a few. Milk isn’t a great source of calcium because it has a low magnesium content and you need magnesium to get the calcium into your bones.

Magnesium: Many fruits and vegetables, whole grains, leafy vegetables, nuts, beans, bananas and apricots – all these make great arthritis foods.

Vitamin D: is required to get the calcium into the bones. The best source is the sun – about 10 minutes per day is fine. Other sources include dairy products and fatty fish.

Trace minerals: Boron and Manganese are important to help the body absorb Calcium; the best sources of Boron are green leafy vegetables, apples, almonds pears and legumes. For Manganese, look for ginger and oats as your arthritis foods.

Collagen & Support Tissues: Collagen is part of our bone matrix, the cartilage in our joints and in the fluid that protects and lubricates our joints. It’s also part of our skin, hair and the connective tissues of the body.

Treating Arthritis foods containing the following nutrients will provide nutrition for bone support: zinc, copper, selenium and beta-carotene (Vitamin A). Green leafy vegetables and pumpkin seeds are good sources of zinc; selenium may be found in brazil nuts from Brazil (because of the high selenium content in the soil); while Vitamin C is found in citrus fruits, berries, red and green peppers, tomatoes, broccoli and spinach. Eggs and meat are good sources of amino acids which form part of the collagen structure.

Essential Fatty Acids – are excellent arthritis foods and are required for the body’s natural pain relief and anti-inflammatory responses. They are also part of the protective joint fluid. Best sources are from fish (particularly oily fish such as salmon and mackerel), animal fat and some oils such as flaxseed (for omega 3)and borage oil (for omega 6).

Regarding essential fatty acids, ideally you should consume Omega 6 EFA & Omega 3 EFA at a ratio of 2:1. Most people find it very difficult to get this right (the average ratio in the U.S. and UK is around 10:1) so we suggest you use an EFA Supplement from a quality source.

Final Note on Treating Arthritis Foods

While it is possible to meet some of your dietary requirements from the food you eat, if you are serious about preventing or reversing arthritis, you need to consume these arthritis foods in combination with nutrient supplements.

Also consider that the majority of the food we eat is grown in minerally-depleted soils – so an almond may not contain all the calcium and magnesium it’s supposed to have, sad but true!

If you have a busy lifestyle, eat junk food and/or can’t get enough fresh food in your daily life, then you should consider supplementing with all 90 essential nutrients including plant derived colloidal minerals and supplements containing vitamins, minerals, amino acids and essential fatty acids.

Calcium and magnesium are normally very difficult to absorb from our arthritis foods diet and from supplements, however, calcium liquid supplements containing Calcium, Magnesium, Zinc, Vitamin D and Glucosamine are a good way to supplement your diet.

Supplements that specifically assist with maintenance and repair of the joint such as Glucosamine, are also beneficial. If you suffer pain and inflammation, then CM Cream has been scientifically and medically proven to relieve pain and improve mobility.

The use of a digestive enzyme supplement – will improve the absorption of the good arthritis foods you eat and will maximize the benefit you receive from taking supplements. As we all reach the age of 40, our stomach acid concentration begins to fall and this can lead to complications of existing chronic disease conditions, such arthritis.
To find out more about treating arthritis foods PLEASE CLICK HERE

Arthritis Suffers Galway suffer only occasional twinges of pain in their joints or have arthritis pain sporadically.Others find that their pain is so severe and debilitating that it affects the quality of life.
The common kinds of pain include inflammation, swelling, pain and stiffness. In some sufferers of arthritis, this may be accompanied by fever, particularly in cases of arthritis pain. People often complain of morning stiffness, when they get up – the range of mobility of the affected joints is reduced.

Artritis Suffers Galway May Find Stiffness

Stiffness can cause its own problems  for Arthritis Sufferers Galway– you may not be able to walk straight and may be advised to use a walking stick for additional support. If the pain is more severe, you may have to use a walker at times during flare-ups.

Additionally, a patient with Arthritis knee pain may find it difficult to get up from a sitting position, be unable to walk fast or run or be able to stand for long periods of time. He or she may not be able to use staircases. A patient with affected finger joints may find it hard to use the keyboard or even do simple chores like cutting foodstuffs, let alone playing the piano or guitar

Joint Pain Affects Artritis Sufferers Galway

Arthritis can potentially affect any joints whether is the jaws, the shoulders, the elbows, wrists, fingers, hips and even toes. Some people suffer from arthritis joint pain in only one type of joint, others have more diffused pain.

While the disease may be more common in older people, it can affect the very young as well. Age, genetic factors, overweight, traumas and injuries as well as repetitive movements can predispose a person to arthritic disorders.

There are many remedies and arthritis Pain management therapies which are available, and also traditional and alternative remedies, in which  arthritis sufferers galway can avail of.

Some people suffer only occasional twinges of pain in their joints or have arthritis pain sporadically.Others find that their pain is so severe and debilitating that it affects the quality of life.

The common kinds of pain include inflammation, swelling, pain and stiffness. In some sufferers of arthritis, this may be accompanied by fever, particularly in cases of arthritis pain. People often complain of morning stiffness, when they get up – the range of mobility of the affected joints is reduced.

Stiffness can cause its own problems – you may not be able to walk straight and may be advised to use a walking stick for additional support. If the pain is more severe, you may have to use a walker at times during flare-ups.

Additionally, a patient with Arthritis knee pain may find it difficult to get up from a sitting position, be unable to walk fast or run or be able to stand for long periods of time. He or she may not be able to use staircases. A patient with affected finger joints may find it hard to use the keyboard or even do simple chores like cutting foodstuffs, let alone playing the piano or guitar.

Arthritis can potentially affect any joints whether is the jaws, the shoulders, the elbows, wrists, fingers, hips and even toes. Some people suffer from arthritis joint pain in only one type of joint, others have more diffused pain. While the disease may be more common in older people, it can affect the very young as well. Age, genetic factors, overweight, traumas and injuries as well as repetitive movements can predispose a person to arthritic disorders.

There are many remedies and arthritis Pain management therapies which are available, and also traditional and alternative remedies, which have reported varying degrees of success. People suffering from this ailment typically try a range of products and therapies to be able to lead a reasonably normal and pain free life.

The relief of arthritis pain can take over a persons life to the extent that nothing else matters. Dealing with  arthritis pain on a daily basis is a very difficult thing to have to deal with.

Exercise can help greatly, even though the person may not feel that they are able to do a lot.  A little bit at the time is the way to start and just keep with it even though there will be days when it seems impossible. Over a short length of time the effects will be noticed, and this  gives a great since of achievement.

Diagnose Arthritis Pain

Juvenile Arthritis Pain is difficult to diagnose and a lot of tests have to be done and also a lot of other conditions have to be ruled out. This is problematic and careful attention has to be given to this.

A personal diet for arthritis pain can be worked out for every arthritis sufferer. A positive mental attitude is of the utmost importance for recovery.