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Date: 03.01.2012
From: Louise Bowling

Subject: MCP joint replacement

Hi,I'm 40 and have RA in both hands, my right hand is the worse. I am a single mum to a little girl who is 7. I have been booked in for an MCP joint replacement of 4 knuckles on my right hand. I am not in constant pain with them but am having flare ups, they are enlarged and slightly deformed. My fingers are showing the first signs of the Unlar Drift where they lie to the side. Should I go ahead with this surgery to improve the look and function of my hand and before the deformaties get worse? or am I better waiting till my hand gets to a stage where I have no option but to have it done? I don't know what would be for the best. Can anyone advise me. thanks, L
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Date: 04.01.2012
From: bsk

Subject: Re: MCP joint replacement

I would go with what the surgeon recommends. They don't do these ops lightly. You need to check this out with the surgeon but I believe if you leave it too long the operation will be less likely to be successful due to erosion of joints and damage to ligaments etc.
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Date: 04.01.2012
From: Colin

Subject: Re: MCP joint replacement

will they sort out the problem with your fingers drifting , was told its cause by the tendons going over the knuckle

would go along with the surgeons recommendation as well , hope it goes well for you
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Date: 04.01.2012
From: Nicola

Subject: Re: MCP joint replacement

Hi, I'm a physiotherapist (and have RA) and I used to work as a hand physio and often treated patients who had mcp (and other joint) replacements. Do not under estimate this surgery! If you are considering this as a preventative measure, maybe see physio and see what splinting options and hand strengthening options are available initially before going under the knife! Post surgery you will be sore, swollen and stiff, you will need considerable physio for several weeks to make the most of your surgery (we would see people 2-3 times a week if we could).you would need to make sure you have considerable support measures in place for those first 6-8 weeks while your joints are healing and you'll be quite limited with household chores, driving etc.
Now on the other hand (excuse the pun) if you are significantly functionally limited now, and your meds aren't managing the disease and significant damage has already been done, the surgery can be great and can make a gigantic difference to your life. But do be prepared for the period post-op when you'll be splinted for several weeks and will need a lot of Physio
Only you know how bad your joints are, try to have a good chat with the surgeon and ask him lots of questions. No disrespect to the surgical profession but they aren't always massively concerned with the issues a patient faces 2 weeks post surgery, they want to make something look better than
it does now, so maybe see if you can speak to the physio and they will give you good advice. Where I worked the physios and hand surgeons were a VERY close team. Good luck, and ask me anything else if I can help x
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Date: 14.07.2012
From: Cynthia

Subject: Re: MCP joint replacement

Thanks Nicola - you just answered my query by helping Louise. I too have been offered four new silicone knuckles on the right hand - and then a fusing and wiring of the oposing thumb in order to give me a grip between forefinger and thumb. I have late stage RA and have no grip whatsoever in either hand. You have given me a realisitic view of the hard work required post-op. Unfortunately I don't think I have any choice but to go ahead and then work hard.
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