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starshine
Posted Monday, November 20, 2006 3:11 PM


 

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I have RA and my right hand is the worst. The rest of my body is in good control with medication. I had my knuckles replaced on my right hand with pyrocarbon joints by Ascension about a year ago. I did not have a favorable outcome. My fingers are more swollen, more stiff and have less range of motion than before the surgery. My pain is finally better but I still experience pain on a daily basis. My surgeon wants to replace the joints with silicone joints. Has anyone had a similar experience? I am very apprehensive. I went to another surgeon for a second opinion and he said that he has not had good luck with the pyrocarbon joints also. He advised having the surgery. Any advice? Thanks for your help. Barbara
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Jane1956
Posted Saturday, February 10, 2007 9:34 AM


 

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I noticed this post is old but if you are still checking it....I had a knuckle replacement years ago and it was the best thing I ever did. My finger is shorter but no pain or swelling. I don't know which one it was but I'd do it again in a heartbeat.
Post #4098873
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Nikki in OH
Posted Saturday, August 18, 2007 4:55 PM


 

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Thanks for the recommendations, BJ. I have had two surgeries on my right hand already, so I am a little familiar with how to cope with just one hand. However, the doctor did tell me about that very odd splint that I would have to wear for a while...looks pretty scary.

Thanks again for the advice. I am leaning more towards doing it now, rather than waiting. Is there a place on here where we can post pics?
Post #4098874
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mumukate
Posted Thursday, October 04, 2007 1:50 PM


 

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hi! i am scheduled for knuckle replacement next week and quite frankly, i'm nervous. i keep thinking that my hand works now, maybe not well, but at least it works! my biggest concern is that i won't be able to play the piano anymore. I can play now out of sheer determination (not as well as i used to before the drifting occured. Can anyone give me some encouragement? thanks!
Post #4098875
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Donna16
Posted Thursday, October 04, 2007 6:35 PM


 

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What kind of material are they made out of? My daughter's ortho(she broke her arm) suggested I go for a consult for a knuckle replacement.She said they have made tremendous advancements in the last 10 yrs-the last time I went. I worry b/c it is my right hand. Keep me posted how it goes. Good luck!

Donna
Post #4098876
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mumukate
Posted Thursday, October 04, 2007 9:47 PM


 

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Donna - I'm not sure of protocol on this forum - were you asking me? If so, they will be using plastic. I was scheduled for surgery today. I was like 10 minutes away from O.R. and they discovered that my "implants" weren't in and they sent me home until next week. Pretty discouraging. This is after they had already performed a total arm block! So, I've spent the day laughing at my dangling arm, trying to sleep off the effects of the sedative they gave me for the block...and having second thoughts! I would really like to see some "before & after" photos. Do you know where some are posted? I read one article today that said a normal joint is 90 degrees movement and the best I can hope for is 45 degrees. Has anyone had better results than that?
Post #4098877
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Donna16
Posted Friday, October 05, 2007 4:09 PM


 

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yes,I was asking you-that is terrible at the last minute they cancelled!!They did not know even after they gave you the block? I do not have pain, but not much function-cant open jars,no strength,etc. They are pretty deformed but I can still type and do certain things. How do you know when it is time? What led you to the decision?
Post #4098878
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Donna16
Posted Saturday, October 06, 2007 12:00 PM


 

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I laughed-even though it is not funny-because only one who knows would understand-at my last rhuemmy appt they did xrays of my hand and I amost cried-did when I got home- b/c all of my fingers are dislocated too and my pinkie is floating-like it fell off-that is how I discribed it too-it is just hanging here! pretty scary-my hand doesn't flatten out either-hasn't in yrs-I can still do some of the things you mention-wash my face,make up etc. I have 2 kids-10,12 yrs old-dont know when the right time would be-

I live in NY so I am sure there are a lot of great surgeons close by in NYC-my ins just changed and unfotunately to a plan that not many drs take-I have to check things out-where are you having it done?
Post #4098879
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starshine
Posted Sunday, October 07, 2007 1:05 AM


 

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For me, the time was right when the hand surgeon said that I was a good candidate for the surgery but if I waited too much longer, I would no longer be a candidate. The other alternative is to have a surgery where the surgeon cleans up the area and realigns the tendons and ligaments. Unfortunately, the recovery time is the same. My fingers were deformed and painful, but not dislocated. They had the ulnar drift and my hand wouldn't flatten out either. It actually does now! Jars and bottles are definately difficult. If you have a Container Store nearby, they have a lot of devices that help with opening jars and bottles. The "under the counter" V shaped bottle and jar opener is the best, though. You can easily open just about any bottle or jar with one hand! BTW, you can post pictures on the RA Connect personal web page. ss
Post #4098880
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starshine
Posted Sunday, October 07, 2007 1:06 AM


 

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I had the surgery and the recovery is much easier this time. I had far less pain and most of the pain is/was due to the cast or splint. They are both very uncomfortable. My therapy is better also. I think that I had an adverse reaction to the former joints. Bye for now, ss
Post #4098881
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starshine
Posted Sunday, October 07, 2007 1:07 AM


 

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Nikki, what surgeries have you had and what are you going to have next? Do you have RA? I know you can post pictures on your profile (Web page)on RA Connect. Please keep in touch. ss
Post #4098882
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mumukate
Posted Monday, October 08, 2007 11:45 PM


 

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Hi, Donna...I'm like you - it's my right hand and that's scarey. The block gave me an idea of what it will be like to operate left-handed only - and it ain't pretty (lol)! My rheumatologist (whom I see every 3 months) recommended I see a hand surgeon just to talk to him to find out the possibilities. He took x-rays and showed me how my 4 fingers are all dislocated. My middle finger is about to "fall-off" (when he said that I gasped!) meaning it is about to become completely disconnected at the joint - that's if I understood him correctly. I don't know how you determine when the time is right - I just know he said it will only get worse with time. From what I understand, this condition can cause the tendons to rupture which is a REALLY bad thing I think. I really don't have much pain either - except for the middle finger...if I twist it wrong or bump it I see stars! Like you, I have to have help opening jars, etc. And you know, it's the little things that are a bother. Because my hand will not flatten out, I use a fist with a dust rag. I can't apply makeup, splash water on my face, pick up small items like coins. I have a picture of my hand as it looks now but I don't know how to post on this forum.
I think it would be a good idea for you to at least talk to a hand surgeon - he'll tell you how bad it is and how much worse he thinks it will get. Let me know what he tells you. Just make sure he has a good reputation and that you like him.
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mumukate
Posted Monday, October 08, 2007 11:48 PM


 

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Hey, SS - Can you tell me about the cosmetic differences after surgery. Will my fingers be straight and my knuckles be smaller? I know it will take a long time to see any cosmetic changes, but I hope evenutally both my hand will look alike. Am I expecting too much?
Post #4098884
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starshine
Posted Friday, October 12, 2007 6:32 AM


 

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My hand is straight for the most part. My index finger still wants to turn toward the pinky but when I hold my hand out straight, it looks normal. The scar is barely noticeable. One thing I did not plan on is my hand itself is about half an inch smaller than it was. The surgeon had to cut off more bone than he thought. I still can't make a fist and probably will never be able to. ss
Post #4098885
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mumukate
Posted Friday, October 12, 2007 6:34 AM


 

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Okay, Donna - you gotta try it! I'm amazed! I had my surgery yesterday and i'm doing FANTASTIC! Very little pain-more like an occasional ache. Nothing that a mild pain med can't handle. They didn't do the arm block again this week and I'm glad - so unnecessary. My cast (or splint) reminds me of my carpel tunnel surgery and I'm in a sling. The badages don't cover the very tips of my fingers, so I can see that my fingers are STRAIGHT! I'm so excited!
Yesterday was a great day - stayed up all day with lots of energy-I even went to a church function for 6 hours and I'm planning on working a few hours today.

i go back to the doctor in 2 weeks for stitch removal and new bandaging - will keep you posted. Have a GREAT day!
Post #4098886
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mumukate
Posted Friday, October 12, 2007 6:16 PM


 

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Just from what I can see, my fingers don't seem to be any shorter. But it's probably much too early to tell. How is your dexterity? How long did it take you to be able to move your fingers? Mine feel REALLY, REALLY stiff - I'm sure it's because of the swelling. They said I was allowed to wiggle my fingers. I hope that is optional cos I really don't want to (lol). Have a great day! mary
Post #4098887
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starshine
Posted Saturday, October 13, 2007 4:12 AM


 

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My fingers aren't any shorter, my hand is. I wiggled my fingers in the cast, but there wasn't much room to wiggle. My fingers were very stiff and they still are. I still wear a night splint and when I take it off in the morning, they are very stiff and take a while to limber up. When you get the cast off, you will probably start OT or PT. I had to take off the traction splint and exercise my fingers every hour. Will you have a traction splint? It is very uncomfortable. How can you go to work? I wasn't allowed to drive. Maybe you work at home? ss
Post #4098888
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mumukate
Posted Saturday, October 13, 2007 6:38 AM


 

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I don't know about what happens when I come out of the cast. My first post-op visit is in 2 weeks and I'll be sure and ask then. My job is less than 1/2 mile from my home anf I only work part-time. I probably shouldn'y be driving either, and wouldn't if it was any farther. I live out of city limits in a small community, so not much traffic. I keyboard & mouse w/my left hand okay - just can't write. So there will be some things I will have to get help on. I work in a small office and there's not alot of pressure or stress.
I'm sorry to be obtuse, but what is OT and PT? The dr did say that it would take 6 or 7 months to get full use of my hand.
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mumukate
Posted Saturday, October 13, 2007 6:49 AM


 

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BTW...I've noticed this morning that there is a place on my arm (elbow area)that is hot and it looks a little red and "puffy" - hate to call the dr. with minor things so I guess I'll just keep an eye on it today. Maybe I should try an ice pack? mary
Post #4098890
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starshine
Posted Sunday, October 14, 2007 12:22 AM


 

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OT is occupational therapy and PT is physical therapy. I just had an OT. she made my splints, gave me exercises to do, and monitored my progress. There aren't many hand therapists around. She is one of only four in the metro Denver area, at least at that time. I would call the doc on that place on your arm. It could be cellulitis, which is an infection. Heat to the area is usually helpful. ss
Post #4098891
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