Orthopaedic & Rheumatology Associates

For Release on November 15, 2011:

Get Better Faster:
Your Health Is In Your Hands

New Rheumatoid Arthritis Treatments Can Restore
Function and Strength While Relieving Pain.

(Davenport, IA) –Twisting a jar becomes painful. It hurts to button a shirt.

The onset of arthritis can be frightening. The prospect of swollen, painful knuckles and eventually disfigured fingers can be worrisome when sufferers begin to experience limits in daily life.

For people who are just beginning to feel the effects of arthritis, though, losing useful hands is no longer inevitable. New surgical interventions offer hope for arthritis sufferers – hope that their hands will not lose the mobility and strength to function.

“There have been tremendous advancements in treating upper extremity and hand arthritis,” says Orthopaedic Surgeon, Thomas VonGillern, M.D., Orthopaedic & Rheumatology Assoc., P.C., Moline, IL. “New technology, surgical techniques and procedures give new hope to maintain a quality of life, even after the onset of arthritis.”

Two primary kinds of arthritis
The word “arthritis” simply means an inflamed joint. Osteoarthritis occurs when excessive wear and tear gradually causes symptoms in certain joints over the course of years.

Rheumatoid arthritis, on the other hand, is a disease that affects multiple body systems including joints, usually on both sides of your body. According to the American Society for Surgery of the Hand, about two-thirds of rheumatoid arthritis sufferers experience symptoms in their hands. (Gouty arthritis, psoriatic arthritis, and post traumatic are three other common types.)


The problem’s progress
Rheumatoid arthritis can be a progressive disease. Anti-inflammatory medicines or disease-modifying drugs can slow it. Those medicines, however, do not offer a cure. “Once rheumatoid arthritis advances significantly, there is enough swelling in the joints and tissue that the joints can get loose,” explains Dr. VonGillern.

“And after a joint’s lining membrane is stretched, the surfaces no longer fit together well. That’s when the joint starts to rub and wears out on one side. The uneven wear and joint laxity results in the deformities of rheumatoid arthritis– as when fingers no longer proceed straight from the hand but instead angle away from the thumb. The looseness and deformities make the fingers floppy and weak.

“If you can catch it before they get stretched out, you can restore function, strength and appearance much more easily, while at the same time relieving pain” he says.


Surgical responses to arthritis progression
Early surgical consultations can be critically important to maximize function and minimize deformity. Preventive surgery may include removing nodules, decreasing pressure on joints and tendons by removing inflamed tissue, or removing bone spurs that may rub on tendons or ligaments. If a tendon ruptures, Dr. VonGillern may be able to repair the tendon with a tendon transfer or graft.

A number of new interventions offer relief from pain, deformity and lost function. “Over the last 10 years,” says Dr. VonGillern, “materials have been developed to allow surgeons to replace worn knuckle joints and restore movement. That is a huge step forward in the treatment of this disease. Before joint replacement surgeries, people had decreased strength and increased deformities. Combined, those significantly diminished quality of life.”

There are several other types of procedures to treat joints affected by rheumatoid arthritis, including removal of inflamed joint lining and joint fusions – usually of the little joints by the fingernails. Choosing the appropriate procedure involves assessing the particular joints involved, the degree of damage present, and the condition of surrounding joints.


Side Bar *****

Think you might have Rheumatoid Arthritis?
Diagnosing rheumatoid arthritis (RA), in the early stages, can be difficult.  While there is no single test, doctors evaluate a patient’s condition against a series of factors strongly associated with the disease.  The American College of Rheumatology uses this list of seven factors:

1.  Morning stiffness in and around the joints for at least one hour.

2.  Swelling or fluid around three or more joints simultaneously.

3.  At least one swollen area in the wrist, hand, or finger joints.

4.  Arthritis involving the same joint on both sides of the body (symmetric arthritis).

5.  Rheumatoid nodules, which are firm lumps in the skin of people with rheumatoid arthritis. These nodules are usually in pressure points of the body, most commonly the elbows.

6.  Abnormal amounts of rheumatoid factor in the blood.

7.  X-ray changes in the hands and wrists typical of rheumatoid arthritis, with destruction of bone around the involved joints.

Rheumatoid arthritis is officially diagnosed if four or more of these seven factors are present. The first four factors must have been present for at least six weeks.

(Source: WebMD)


About Dr. Thomas VonGillern
Dr. VonGillern has special interest in the shoulder, elbow, wrist, and hand. He completed a fellowship in surgery of the upper extremity, hand, and microsurgery at Columbia University, New York. He is the team physician for Rock Island High School.


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Photograph – Arthritic Hands (1.6MB)

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