You said, "I can't believe all they are able to do with so much that noone can help us, as far reconstruction of fingers and inject some sort of replacement cushion, where I have none." That is certainly a good question, and one that several people I know would like to have answered.

First, keep in mind that the idea of injecting a replacement cushion is definitely being tried --- but even on larger joints, the results are extremely mixed. A few things are helpful to some people, but the experience is not there yet to tell what will work for each individual. There can be side effects, including rejection or allergic reaction by the body, missing the injection target, with possible complications, migration of the substance to the wrong place (causing their own side effects) Even when it works, the length of effectiveness can vary greatly between individuals.

The ability to inject almost-microscopic quantities precisely into small joints is hugely difficult. It took me several years to find an orthopedic surgeon able to precisely inject cortisone into my failing thumb joint and get it right every time. I believe it would take development of a robotic, x-ray-guided process.

Some finger and thumb reconstruction is possible, but in a body with erosive arthritis, even those can be temporary, and may not provide the usability or pain relief you might expect, because other joints may continue to erode. For example, the carpectomy I had 10 years ago to maintain use of my wrist is beginning to fail - next week I will find out if there is another conservative surgery or if it will need to be completely fused.

So the short answer is, they are working on it, but it's not there yet.

If you are interested in pursuing treatment, I recommend you find the very best hand and finger surgeon you can (usually a plastic or orthopedic surgeon with extra training.) Then ask for help to find the latest reliable solutions for your hands and who does the procedures A LOT. For example, my current hand surgeon says there are 4 techniques for repairing the CMC joint in the thumb, with numerous variations on each. He told me which he preferred, and why, showed me the success, revision & failure numbers in general & his own. I had my second hand done last year & I'm very happy with the results.

Have you been seeing a rheuatologist? She may be able to refer you to a hand surgeon.
Sue

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