Ask the Expert: Rheumatoid Arthritis, Celebrex, and Surgery

Mark Borigini, M.D. Health Pro
  • Dear Dr. Borigini,

    My father (72 years old) has Rheumatoid Arthritis in his hand. I would like to know if an artimplant spacer will work for his condition, or if should he try hyalgan before. He had a triple heart bypass about 4 years ago and he has being using Celebrex to control the pain.

    If your father suffers from rheumatoid arthritis, and his disease is active, then he would probably be a candidate for disease modifying medications—assuming there are no contraindications. Hand surgery for rheumatoid arthritis is a rather common occurrence, but it is usually done to correct deformities in patients whose disease is relatively under control, or to remove stubborn inflammatory tissue around a joint (synovectomy) or tendon to avoid damage to those areas. Hyalgan is used in osteoarthritis; it is FDA approved for knees, not finger joints. Celebrex is used in both osteoarthritis and rheumatoid arthritis. You mention that your father had heart bypass surgery, and I am sure you are aware of the concerns regarding drugs such as Celebrex and the risk of heart disease.
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    It seems that every time one scientific publication announces how dangerous Celebrex is, a short time later another publication concludes the opposite. Well, here is the latest information: An analysis published in the January 1st, 2007 issue of The American Journal of Cardiology concluded that there was no difference in the incidence of cardiovascular events in patients taking Celebrex compared to those taking some of the older anti-inflammatory drugs, or those taking placebo for up to one year of treatment exposure. The definitive study will most likely be the one now underway, which is comparing the safety of Celebrex to ibuprofen and naproxen. However, those results will not be available for at least another three years.

    Important: We hope you find this general medical and health information useful, but this Q&A is meant to support, not replace the professional medical advice you receive from your doctor. For all personal medical and health matters, including decisions about diagnoses, medications and other treatment options, you should always consult your doctor. See full Disclaimer.
Published On: January 10, 2007