I have had diagnosed RA 15 years this June. Last week upon a routine visit to my RD, she told me I had a flexor tendon that had jumpcess to some wonderful orthopedic surgeons. I have an appointment next Friday. Can ced the track. She sent me to an occupational therapist who agreed and mentioned that the one next to it is on the brink and hovering on jumping the track. The OT told me if I didn't have surgery eventually because of my RA, my displaced tendons would rupture, requiring immediate surgical repair. I am fortunate to live in the Chicagoland area and have an appointment next Friday for an evaluation. My RD told me I would also be a candidate for replacement joint surgery in the hands. I already have deformities and have little muscle left in either hand. My RD says this is a major surgical procedure and it requires intensive rehab. Can anyone shed some light on what all this entails and if I wait will the tendons rupture? Thank you
8 Tips for Coping with Lupus 
10 Ways Lupus Affects the Body 
Conditions That Mimic Rheumatoid Arthritis 
5 Tips for Exercising with Lupus 
I have had multiple surgeries in my life, including two hip replacements, but I've yet to face anything related to my tendons. However, it sounds to me as if you are potentially in a situation akin to discovering a major issue with the plumbing in your house. The kind where that great saying applies - 10 minutes of maintenance saves you 10 hours of repair.
I could imagine that this kind of surgery might be easier and more likely to have a good result if it's done before the tendon ruptures. After the tendon ruptures, you're looking at potentially complete inability to use your hand until you have surgery and I could also imagine that repairing the tendon might be more difficult than the procedure that has currently been recommended for you. I would suggest that you discuss this in more detail with your RD and/or the occupational therapist to whom you were referred, as they are more likely to be able to share pros and cons and potential consequences of waiting.
We do have a number of posts about surgery for RA where you can find more information, including a post about soft tissue surgery (including tendon repair) and one about joint replacements in the hands and fingers. As you'll see in that post, this type of joint replacement is trickier than the bigger joints, such as hips and knees - those are somewhat simpler surgeries, and have been done for decades, so generally have a higher success rate. I'd recommend that you read the material on our site, as well as Google joint replacement in your hand to get a better sense of the kind of questions you should ask of a surgeon.
good luck! Please keep us posted on what happens?
Thank you Lene ffor your honesty. My RD did explain this was a surgery I should not rush into without all the facts, and that is pretty much what you are saying too. It was the OT that told me about the rupture not my RD, but then she may not have wanted to put the horse before the cart. Instead encouraged me to see the OT to see if she could do anything for me that would not include an invasive procedure. I see her Wednesday the surgeon Friday, so I will have facts and questions ready to fire at the doctor. I am hoping he will tell me the surgery can wait awhile, but not confident that he will. I have made an appointment with a top doc in his field, and am looking at a very fine teaching hospital in the Midwest. Thank you again for responding so quickly. I will post my findings once I see the surgeon.
not to rush you or anything, but... how did it go?
I severed two tendons in my left pinky. Anyone NOT have the surgery? I would like to know how you made out.
Lene,
Ironically seeing the surgeon today. I am rather anxious. Have a second opinion lined up later this month if I deem necessary. My biggest hangup will be that if I do need surgery my RD says it needs to be at the end of a cycle of my rituxan treatment. Since I don't want to have to put off the rituxan becausse it is making a world of difference timing will have to be right. I will let you know what the surgeon says. I am armed with a list of questions, number one on my list is his expertise with RApatients. It seems we are a different breed when it comes to surgery because of our supressed auto immune system. Thanks for checking up on me Lene.
Sandy - ouch! That sounds awful!
I recommend that you put this in the SharePost or a question in the Q&A section. Not a lot of people see the comment section in SharePost, so it's unlikely that you'll get a lot of eyeballs on your question. However, if you put it in SharePost, it'll be more visible.
you are as prepared as possible and definitely have all the trademarks of being an empowered patient. Good for you! Will keep my fingers crossed for you today.
Lene,
Great news today! First of all I was taken back by the facility of Rush hospital in downtown Chicago. It's enormity was overwhelming. My ortho guy was in the orthopedic building and his practice was expansive and also very impressive. He had signed footballs from Dan Hampton ( to my particular surgeon) and another from Roger Staubuck. Hockey jerseys were behind glass hanging on the walls. Each specialty in the practice had its own check in area and each doctor had a special person to greet you. My doctor was the blue section, hand, wrist and elbow. Although I was asked to bring my x rays they took there own and were uploaded to his computer when he came in to see me. He was very nice and told me I had and I quote "beautiful hands," He said my extension was perfect and the sway and the deformities and nodules did not merit surgery. He also told me that although the flexor tendon was off its band it was in "no emminent danger of rupturing." He told me he trained with a renowned doctor that worked with RA patients. Infact, he said when his practice began, he saw 3 people a week with RA needing surgery. He said with the new drugs it has been over a year since he saw a patient for that. He also said there was zero benefit in replacing my knuckles now or wait to see if they get really bad. All in all I was in shock and as blindsided as I was when myRD told me to see a hand surgeon, and the OT made it seem necessary, that is how blindsided I am feeling now about what he told me. I have faith his recommendations are correct and I am happy to avoid any surgery at this time. So thank you for keeping tabs on me and thank goodness no surgery! This somehow reinforces to me to stay away from doctors! I know my body best. I think my RDtold me to see a surgeon because it was out of her realm of expertise. The OT on the other should be called to task for scaring the heck out of me.
so glad to hear the good news! OTs are usually good people with lots of knowledge, but they aren't surgeons. And it sounds as if you found a very good surgeon! Are you still going for the second opinion?
Thanks for letting me know how things went. Have a great weekend!
Hi Lene
Please let me first introduce my self for you i'm Ahmed HAMDY i'm searching through internet since couple of weeks for prper treatment for RA,
Actully not for me but for my wife and i think part of the treatment will be hand knuckle replacement surgery for both of her hand as first step.
But you can say iam flying blind looking forward for trusted place have good experience in such like treatment for RA moreover the surgery too.
Last i would like to know as per your experience how much like medecal treatment and surgery will cost.
Thanks inadvance for your efforts.
Looking forward to hear from your side, and your prompt responce will be highly apprechiated.
you can contact me too on my personal mail
a_hamdy0305@hotmail.com.
Regards
Ahmed HAMDY
That's an interesting question - I recommend you ask it in the SharePost or on our Facebook page. It will get more "eyeballs" when your question than a comment in a post.
that's really great news!
Would you be willing to share that story in the SharePost? I think this would be really valuable information for our community to hear., Both in terms of accepting recommendations as suggestions, but waiting until you see an expert before you get scared and the story your surgeon told you about the decrease in seeing people we need hand surgery. Both are very important.
Congratulations!