Erosive Osteoarthritis

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

Thank you for your response. Appreciate the information. Yes I saw the RA specialist as mentioned above. She did say if I wanted, she would refer me to a hand specialist. Although I am a more of natural ways, I am going to give Plaquinal a chance as I do notice a difference with inflammation and pain. Not that I want to be on it forever.... Feedback though has been positive of those I know on it for RA, seems to help my Erosive OA for now. Still a bit of a twinge here and there BUT I realize it won't happen over night.

Thank you for your response. Appreciate the information. Yes I saw the RA specialist as mentioned above. She did say if I wanted, she would refer me to a hand specialist. Although I am a more of natural ways, I am going to give Plaquinal a chance as I do notice a difference with inflammation and pain. Not that I want to be on it forever.... Feedback though has been positive of those I know on it for RA, seems to help my Erosive OA for now. Still a bit of a twinge here and there BUT I realize it won't happen over night.

In reply guess, I am lucky to have 3 ortho surgeons that can inject both thumbs, one shoulder (now that the other one has been replaced), and my one foot(big toe joint and right in the middle where there are no cushions left) I go every three months and have been for many years. Hope they do not retire. But they want me to go to plan B which is surgery on my thumbs but will do injections as long as they work. If I have to wait longer to have injections then it is bone on bone with pain. Along with losing bone. I have never been on any Rx just injections. I hope you find some help soon. Keep in touch with your progress and stay safe.KLH

A cautionary tale for you regarding your thumbs. When my thumbs got to the point where injections weren't lasting 4 months, the ortho surgeon took new x-rays, and told me I was in the "sweet spot" - the repair surgery would still work. He warned if I waited until the joint collapsed due to bone deterioration, the only solution would be full fusion of the joint. Two friends were given the same caution by their docs that autumn. Two of us elected the conservative surgery ASAP, the third decided to wait, and see if somehow the thumbs would heal.
Two of us now have nearly full, pain-free use of our thumbs to paint, sew, etc. The guy who waited has fused thumbs on both hands, and had to give up his favorite hobbies, as well as rig a special harness so he can still use his big SLR camera to take wildlife photos. So be sure your ortho frequently x-rays the thumbs for comparison...
Sue

What do they do to repair your thumbs? They changed the procedure since the doc and I talked. I did not know it changed 4 years ago and they do it differently rather than use a tendon from your arm. How long was it till you could use your hand and wrist? I am left-handed and my right is pretty useless and has no strength since my rotator cuff is torn. I can choose anytime I want surgery, just make an appt. But with Covid and the farm and no family around, it is hard to find the right time and which surgery comes first. Thanks for your input.KLH

It is called CMC repair. The newer technique is called the tightrope, which doesn't use any tendon, which simplifies both surgery and healing. About 6 weeks the hand can be used for routine, but not heavy tasks. My advice is non-dominant hand first so it will be as strong as possible to sub for the dominant one when the time comes.

For sure count on hiring someone to throw bales, fix fences, etc for a good 3 months. Even now, I wear braces on both hands for heavy tasks like hauling dirt and rocks, hammering, etc.

Does this help? You can easily Google to see the technique.
Sue

Thanks, Sue that was a fast reply. As my daughter would saw as we drove to town 6 miles, wow that was a fast ride to town. He has been doing I guess the tightrope for over three years. Are you in a sling for a while? How much PT did you have to go to? Sorry for all the questions? I do not know anyone who has had the surgery performed. All new hires are younger and not much hand pipetting for them. The machines do the work now. For me, the damage was done a long time ago. Being retired will help and no sheep chores since we sold the whole flock which we have had since 1979. I am sad but when your hands and arms are giving out after all these years and chores are getting harder especially during lambing, you have to cut back. Stay connected I love the feedback KLH.