Collagenolytic systems in rheumatoid arthritis.

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Abstract

[Indexed for MEDLINE] 6. J Am Acad Orthop Surg. 2007 Feb;15(2):118-25. doi: 10.5435/00124635-200702000-00006. Reconstruction of the rheumatoid thumb. Rozental TD(1). Author information: (1)Department of Orthopaedic Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. Thumb deformities are common manifestations of rheumatoid arthritis and represent a significant source of disability. A clear understanding of the pathophysiology of the disease is essential in directing treatment. Differential diagnosis for flexible deformities includes soft-tissue imbalances as well as tendon ruptures. In its early stages, thumb involvement can be treated nonsurgically or with soft-tissue reconstruction. With more advanced disease, arthrodesis and arthroplasty often are required. Isolated interphalangeal involvement is best addressed with arthrodesis. Metacarpophalangeal involvement can be treated with arthroplasty in low-demand patients or with arthrodesis in more active patients. Trapezium resection arthroplasty provides excellent relief for patients with carpometacarpal joint destruction. DOI: 10.5435/00124635-200702000-00006