Dr. Steven Rueda is one of the most sought after surgeons for wrist arthritis in Palm Beach. Osteoarthritis, commonly known as arthritis, can occur in any of the joints of the wrist. The word “arthritis” means inflammation in the joint. The symptoms can be very debilitating and limits people from doing basic every day activities.
Wrist Arthritis Symptoms and Diagnosis
The symptoms arising from wrist arthritis are caused by the bone-on-bone rubbing as well as the inflammation inside the joint. The two most common joints involved in wrist arthritis are the “radiocarpal joint” and the “distal radioulnar joint”. Some of the most common symptoms include:
- Pain at the wrist with bending
- Pain at the wrist with twisting
- Swollen and puffy wrist
- Cracking and popping when moving the wrist
- Decreased range of motion with wrist movement
In some cases patients present with all of the symptoms, and in some cases only with some of them. Other conditions like a wrist sprain and wrist synovitis can cause similar findings.
The diagnosis of wrist arthritis is usually performed by clinical examination, history, and xray imaging. Dr. Rueda uses xrays to confirm the diagnosis and verify that there is loss of cartilage and bone-on-bone contact. In some cases, CT scan is necessary to plan for potential treatment, however it is not typically used for diagnosis.
WHAT CAUSES Wrist Arthritis?
The cause of arthritis is poorly understood. It is however more common with age and after trauma. The wrist if formed by two bones of the forearm (radius and ulna), and the carpal bones connecting the forearm to the finger bones. The most commonly involved carpal bones in wrist arthritis are the scaphoid and lunate bones. The normal joint anatomy consist of the two ends of a bone covered by a cartilage cap or cartilage surface; the space between the two surfaces is covered with joint fluid that assist in lubrication. In wrist arthritis, the cartilage in the surface wears out leading the forearm bones to be in contact with carpal bones (See Image). This rubbing of bone-on-bone leads to the pain and inflammation seen in arthritis.
Wrist Arthritis Treatment Options
There are three main ways to treat wrist arthritis: braces and splints, steroid injections, and surgery. Modern medicine has not found a cure for arthritis, however, there are excellent ways to manage it. The main goal of arthritis treatment is to control pain, and remains the focus of all interventions. A secondary goal is to increase the range of motion of the joint.
Braces and splints do not cure arthritis but help control pain and inflammation with immobilization of the joint. This minimizes the rubbing and grinding of the bone-to-bone interface. A wrist brace is typically prescribed for most patient’s with wrist arthritis, and works particularly well for those with recent onset of symptoms.
Steroid injection is an alternative that reduces the inflammation and improves pain in the joint. It is done in the office setting and is very well tolerated. In most cases it provides symptoms relief from days to months, and in some rare situations even years. The injections can be repeated when symptoms resume, but this is not recommended sooner than every 6-8 weeks.
Surgery is indicated for patients who have failed treatment with braces and steroid injections.
Wrist Arthritis Procedure
There are three main types of wrist arthritis surgery: wrist denervation, wrist fusion, wrist replacement (arthroplasty). Dr. Rueda is an expert in all of these procedures, and has presented on the subject in national meetings. Some of the differences across the types of surgery are listed below:
All of the previous procedures are performed using a vertical incision in the back of the wrist of 5-8cms long
Goals of Surgery
• Wrist denervation:
Removes the nerves of the affected wrist joint to reduce symptoms of pain
• Wrist Fusion:
Fuses or joins the two raw bones that are rubbing together in the joint using wires, plates, or screws; it avoids pain by eliminating movement at site of the joint
• Wrist Replacement:
Replaces the bone ends with implants; it avoids pain by preventing bone-on-bone contact while preserving motion.
RECOVERY AND DOWNTIME
• Wrist Denervation: Outpatient procedure. Most patients are actually surprised at having less pain that they expected. There is tightness, swelling and bruising for first few days after surgery. An elastic bandage is applied and removed in five days. The patient begins therapy to gradually increase the movement in the wrist joint.
• Wrist Fusion and Replacement: Outpatient procedure. Patients receive a nerve block to minimize pain after surgery. There is tightness, swelling and bruising for 2-3 weeks after surgery. A splint is worn for 4-6 weeks. The patient begins therapy to gradually increase the movement in the wrist joint after splint removal.
• Wrist denervation: Most patients generally return to work in 1 week when the incision is healed. Weight lifting and heavy manual exercise is not allowed until 3 weeks after the surgery.
• Wrist Fusion and Replacement: Return to work depends on the activity and profession. Those whose profession does not require strong manual activity of the hands usually return to work for basic tasks in 2 weeks with the splint in place.
Why Choose Precision Hand Center for your Wrist Arthritis Procedure?
Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for wrist arthritis. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in peer reviewed expert journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the wrist arthritis treatment Palm Beach can offer.
FREQUENTLY ASKED QUESTIONS (FAQ)
Patients with classic history, symptoms, and exam who have failed conservative treatment are good candidates for the procedure.
Fortunately the treatments are all excellent at getting rid of the pain. Most patients feel the arthritis pain “gone” after the procedure while they recover from the different “procedure pain”.
Complications in arthritis surgery are specific to every procedure. Dr. Rueda will discuss these with you personally. Fortunately these procedure are safe and enjoy very high success rates with low complication rates.