It is widely accepted that rheumatoid arthritis (RA) can cause severe suffering. A promising method in clinical treatment, finger joint replacement surgery, has attracted great attention in both research and clinical practice. Here, the human finger joint structure is first introduced, and one of the common diseases - RA - is then identified. Following that, finger joint replacement surgery is briefly interpreted. Research problems are then identified on the basis of an analysis of current finger joint replacement methods.
7.1.1 Structure of a human finger joint
The typical configuration of human finger joint bones is illustrated in Figure 7.1 (Strete, 1997).
Arthritis is a disease that can cause painful inflammation of joints and even breakdown of the joint structure. Arthritis, in particular rheumatoid arthritis (RA), affects hundreds of millions of patients throughout the world, causing pain, deformity, stiffness, weakness and incapacity. In particular, smaller peripheral joints such as the proximal interphalangeal joints (PIPJ) are the
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most commonly involved joints when RA affects the hand. Figure 7.2 (Fishback, 1999) shows a radiograph of a hand in late-stage RA, illustrating the subluxation of the metacarpophalangeal joint (MCPJ) and ulnar drift of the fingers. It can be seen from this image that the patient suffers severe joint displacement, rendering the hand immobile.
RA affects about 750 000 people in the United Kingdom and is the biggest cause of pain and disability. In Hong Kong there are about 1.1 million people over 60 years old (from the year 2001), and 0.4% of them (4400) are likely to develop RA. About 25% (1100) RA cases are severe enough to warrant implantation of artificial finger joints. There were approximately 120 finger joint replacements carried out in Hong Kong each year from 1996 to 2000, requiring about 2-8 artificial finger joints each, depending on the philosophy of the surgeon and the extent of the damage in the patient.
During the early stages of arthritis, the disease may be treated with drugs or physiotherapeutic techniques. In later stages, synovectomy and soft tissue reconstruction may be applied to
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