Diagnosis
Osteoarthritis is diagnosed though listening to your symptoms and history, and an examination of the affected joint(s). An X-ray may also be taken to understand the extent of the damage of the joint.
Treatment options
- Watch and wait: It is possible to take no action if the symptoms are not bothersome or manageable.
- Pain management: Anti-inflammatory painkillers can be very helpful to many, as well as changing how you use the affected joint. Splints can also be worn to support the affected joint such as wrist splints, thumb splints or finger splints.
- Movement: Regular gentle stretching is useful
- Steroid injections: If the above become ineffective these can be provided in The Hand to Elbow Clinic (often at the same time as your consultation). Success cannot be guaranteed, but 70-80% of patients experience significant benefit. The benefit experienced lasts anywhere from weeks to years with only mild symptoms.
- Surgery
- Debridement: This is when the joint is ‘cleaned out’, with abnormal bone, inflammatory tissue and any contracted ligaments released. This is usually an open surgery for smaller joints, and keyhole surgery for larger joints. This aim is to reduce pain and increase movement of the joint.
- Arthroplasty (joint replacement): It is possible to have elbow, wrist, finger joint (except for at the end of the finger) and the base of the thumb joint replaced. These can be effective, but they are not as good as hip or knee replacements. Once the joint is replaced, absorbable sutures are used and a protective plaster cast is applied. Careful follow up plans are key to success of the operation with physiotherapy and a splint if indicated. 85% of patients report good – excellent results.
- Joint fusion: This is used in the wrist, and the finger joints (except the finger (MP) joints). The operation creates a bony link between two bones by trimming the two bones and joining them with screws or wire. Absorbable sutures are used and a plaster cast applied to support the area. Careful follow up plans are key to success of the operation with physiotherapy and a splint if indicated. 85% of patients report good – excellent results.
