Rheumatoid Arthritis (RA) is a chronic disease characterized by severe inflammation that leads to degradation of articular cartilage and the formation of bony erosions. Currently, certain anesthesiologist-led pain management clinics have begun to take on a collaborative role in the treatment of patients with RA, as this progressive disease impairs work capacity due to chronic pain. We present three clinical cases in which platelet-rich plasma (PRP) was used for the treatment of RA in patients seeking a new therapy for pain control and improved range of motion, specifically in certain joints of the hand. The Patient Activity Scale II was employed as a standardized method to assess RA disease severity, recorded on the day of injection, at one month, at three months, and at six months. All of the included patients, ages 49, 60, and 63, had an established diagnosis of RA affecting the proximal interphalangeal and metacarpophalangeal joints of the hand. Over the course of six months, two out of three patients reported a 20% reduction in pain from the initial visit and a 30% improvement in overall well-being. The third patient noted a 50% decrease in pain from the initial visit and a 50% improvement in overall well-being. PRP treatment consistently resulted in functional improvement for each of the three patients treated, while also reducing long term pain and inflammation. Initial clinical and laboratory studies have shown that autologous plasma rich in platelets serves as a source of an abundance of growth factors once activated. The multitude of these growth factors injected into and around the diseased joints improves functionality in patients with RA indicating PRP may be a safe and beneficial therapy in patients with RA primarily affecting the joints of the hand.
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http://dx.doi.org/10.7759/cureus.19629 | DOI Listing |
J Hand Microsurg
January 2025
Department of Orthopedics, Hand, and Reconstructive Microsurgery, Olympia Hospital & Research Centre, 47, 47A Puthur High Road, Puthur, Trichy, Tamilnadu, India, 620017.
This article introduces a surgical technique for cross-intrinsic transfers (CIT) to correct ulnar drift in rheumatoid hands performed under wide-awake local anesthesia no tourniquet (WALANT). This approach allows real-time adjustment of tendon transfer tension and active patient participation in hand movements and deformity correction during the procedure. It can be combined with other surgeries such as prosthetic replacement arthroplasties of the MCP joints.
View Article and Find Full Text PDFRheumatol Int
January 2025
Clinic of Rheumatology, University Hospital St. Marina, Varna, 9010, Bulgaria.
Hand osteoarthritis (HOA) is a heterogeneous joint disease with high radiographic and symptomatic prevalence. The diagnosis of HOA is based on clinical and radiographic features. The identification of potential biomarkers for diagnosis, prognosis, disease severity assessment, and therapeutic efficacy evaluation of НОА remains an active area of research.
View Article and Find Full Text PDFJ Plast Surg Hand Surg
January 2025
Department of Hand Surgery, Huashan Hospital Fudan University Shanghai, China; Department of Hand and Upper Extremity Surgery, Shanghai Jing'an District Central Hospital, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; NHC Key Laboratory of Hand Reconstruction, Fudan University, Shanghai, China.
Introduction: This study presents an innovative arthroscopy-assisted total wrist arthrodesis technique utilising three hollow screws, aimed at improving clinical outcomes for patients with severe wrist arthritis.
Materials And Methods: The technique involved the placement of three hollow screws to facilitate wrist bone fusion. Between August 2019 and August 2023, four patients diagnosed with severe wrist arthritis underwent the arthroscopy-assisted procedure.
J Clin Orthop Trauma
March 2025
Department of Hand and Reconstructive Microsurgery, Singapore General Hospital, Singapore.
Wrist arthroscopy presents a significant learning curve, necessitating various precautions to avoid complications like tendon laceration or nerve injury. Arthroscopic procedures become even more challenging in arthritic wrists due to altered anatomy and reduced joint space, which in turn increase the risk of complications. In this review article, we offer tips and tricks to minimize these risks.
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Management of the extensive soft tissue injuries remains a significant challenge in orthopedic and plastic reconstructive surgery. Since the thumb is responsible for 40% of the functions of the hand, saving and reconstructing a mangled thumb is essential for the patient's future.
Case Presentation: This case report describes the management of a severe occupational thumb injury in a 25-year-old white Persian male who sustained an occupational injury to his left thumb, resulting in extensive burn, crush injury to the distal and proximal phalanx, and severe soft tissue damage to the first metacarpal, thenar, and palmar areas.
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