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Categoría: Pulgar

Nuevo herald portada
Artículos de Pacientes

Reemplazo de la articulación del pulgar (artritis del pulgar)

Novedoso reemplazó de la articulacion del pulgar El ortopedista Alejandro Badia reemplaza la articulación de la la base del pulga, afectada por la artritis, por una de titaniumPublicado por El Nuevo Herald 2010 Click aqui para ver el procedimiento en Español Click aqui para ver el procedimiento en Ingles Reemplazo de la articulación del pulgar (artritis del pulgar) Reemplazo de la articulación del pulgar (artritis del pulgar) Options for Treating a Painful, Arthritic Thumb Options for Treating a Painful, Arthritic Thumb Whats causing your thumb pain? Whats causing your thumb pain? Want to see more articles? BHS Blog Scientific Publications

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atroscopia pequeña articulación pulgar
Artículos de Pacientes

Opciones para tratar la artritis del pulgar

Treatment Options for a Painful, Arthritic Thumb Health News Digest 2020 Pain relief is more available than ever for treating a painful arthritic thumb, thanks to the development of ever-newer technologies, says Miami-based orthopedic surgeon Alejandro Badia MD.  Dr. Badia, a noted specialist in disorders and injuries of the hand, wrist and upper limbs, is using the BioPro® Modular Thumb Implant as an effective alternative for relieving osteoarthritis of the joint at the base of the thumb – the basal joint. He says such advances in biomaterials could supersede what has been, until now, the gold standard” for surgical treatment – LRTI. LRTI, normally performed as an outpatient procedure, involves removal of the thumb joint’s trapezium (carpal bone) and then a transfer of a tendon from the patient’s forearm to the trapezial space to stabilize the area and prevent collapse of the joint. Although experts contend LRTI provides “95 percent pain relief” and up to 80 percent return of gripping strength, the surgery has some major drawbacks. “Removing the trapezium may shorten the thumb and leave patients few other options if symptoms persist,” Dr. Badia states. He adds that recovery from this kind of surgery also can be prolonged and painful. Thumb ligament reconstruction without excising the arthritic bone may prove helpful if a patient only experiences a loose tendon, but no loss of bone cartilage, due to disease, Dr. Badia says.Another common approach is basal joint fusion or arthrodesis which has its cons as well. It is usually limited to a patient’s non-dominant hand because the surgery is “associated with decreased range of motion,” transfer of normal forces in the thumb to other hand joints and a lack of complete fusion of bone at the thumb’s base, according to authors of a 2017 report in Orthopedic Reviews. “Another option is arthroscopic reconstruction which I tend to use in younger, higher demand patients and when alternatives to surgery are sought. The use of Protease Inhibitors (like PRP on steroids!!) has shown promising results in early follow up of patients with this new modality of treatment,” Dr. Badia says. As the population ages but continues to be increasingly active, more effective approaches will be needed to provide pain relief from this debilitating osteoarthritic condition, while maintaining strength and range of motion in the thumb,” says Dr. Badia, founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®, a walk-in orthopedic care clinic. Dr. Badia calls advances in artificial joint implants like the BioPro® a “step in the right direction.” Other scientists concur. For example, in a February 2019 Journal of Hand Surgery (European Volume), authors write that, in a four-year follow-up, patients who received an advanced thumb-joint prosthesis – in this case, an Ivory® implant – experienced “significantly better thumb abduction, adduction, grip strength, pain relief, satisfaction and faster return to daily activities and previous work” than those who had undergone LRTI. The study included nearly 150 patients.“Advancements in implant design and materials are overcoming the tendencies of older prosthetic versions to fracture, dislocate or simply fail to relieve pain and improve thumb function,” Dr. Badia explains. Arthroplasty of the thumb is much like a total knee or hip replacement. All or part of the thumb joint is removed and replaced with a prosthesis. Dr. Badia Associated with aging or previous thumb injury, osteoarthritis of the basal joint is the second most common arthritic condition of the hand, affecting approximately 15 percent of those above 30 years of age and about a third of postmenopausal women. The disorder, which leads to collagen loss and, in its later stages, bony overgrowths on the trapezium, can result in severe pain and loss of grip function and strength.  Physicians normally pursue conservative treatment approaches for patients in early stages of thumb arthritis, including use of anti-inflammatory medications, injection of corticosteroids, thumb splinting, and physical therapy. However, “these treatments are unable to alter the inevitable course of the disease’s progressive pain — and even thumb deformity — leaving only surgery as next line of defense,” Dr. Badia says. “Main advantage of total joint surgery is that no bridges have been burned,” Dr. Badia adds. “If a patient’s symptoms persist, the thumb implant can be readily removed, and another surgical procedure performed.”  Facebook Twitter LinkedIn Email Arthroscopic Options for Treating a Painful, Arthritic Thumb Arthroscopic Options for Treating a Painful, Arthritic Thumb Whats causing your thumb pain? Whats causing your thumb pain? El uso de móvil y consolas provoca daños al pulgar? El uso de móvil y consolas provoca daños al pulgar? Want to see more articles? BHS Blog Patient Articles

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dolor en el pulgar
Artículos de Pacientes

¿Cuál es la causa de su dolor en el pulgar?

Whats causing your thumb pain? Anti-inflammatories, splinting, or even corticosteroid injections simply diminish symptoms but do not provide a long-term solution. Anti-inflammatories, splinting, or even corticosteroid injections do not alter the often inevitable course of progressive pain and even deformity. What is osteoarthritis ? Most typically basal joint arthritis, is the second most common location for arthritis in the hand but the most functionally disabling. The func­tion of thumb opposition and subsequent pinch are crucial for such daily activities as turning a key, opening a jar, or picking a small object off the table, No wonder pain and weakness from the base of the thumb is so functionally disabling! Conservative treatment for Basal Joint Arthritis: The initial treatment of symptomatic basal joint ar­thritis is most often for pain relief. Anti-inflammatories, splinting, or even corticosteroid injections simply diminish symptoms but do not provide a long-term solution. They do not alter the often inevitable course of progressive pain and even deformity. Therapy can play a role in conservative treatment, but in severe cases it can actually aggravate symptoms. A wide variety of splints are available that allow the joint to rest and may minimize the pain, but the very fact that  motion of this joint is important for hand function underscores the need for something other than splinting. Nonsterodial anti-inflammatories (ibuprofen/ Naproxen/Cox-2 inhibitors) have only a temporary effect and are used simply for marginal symptomatic relief. The gastric complications of using these drugs should not be overlooked and patients should not use them long-term when seeking relief from simply one joint in the hand. Injections for thumb pain? Corticosteroid injections have a more prolonged effect but can have long-term deleterious effects on the joint cartilage or capsule. Persistent pain demands that something more definitive be instituted for treatment;. and for this reason, sur­gery has generally been the most effec­tive treatment in symptomatic .cases. Surgical Option: LRTI The problem is that until recently, there have been few surgical options, and those were often quite pain­ful and required a prolonged recovery. One of the earliest surgical treatments was complete excision of the trapezium, a small bone at the base of the thumb within the wrist. This simple operation was first de­scribed over 50 years ago. A more complex version of this procedure is termed the LRTI (ligament reconstruction tendon  interposition) and has become the most common­ly used surgical procedure for treatment of painful basal joint arthritis’.  This relatively complex operation combines several previously described procedures including the complete removal of the trapezium bone and the stabilization of the metacarpal base using a strip of a wrist tendon. While reports in the hand surgery literature are generally favorable in terms of the outcome, several problems remain with this operation. One of them is that the recovery. process is relatively long and can be painful. However, the main problem lies in the fact that there are few salvage op­tions if painful symptoms persist because the trapezium has been completely removed. Once this bone, the pillar base of the thumb, is removed, there are few remedies  available to reconstruct the thumb should the need arise. Similar problems occur after fusion, which eliminates motion because the adjacent joints, which are frequently ar­thritic as well, can become symptomatic. Reversing a fu­sion is a formidable task and joint replacement maybe the only option. Learn more about thumb joint replacements Thumb joint replacement Like in , so many other joints, metal/polyethylene joint replacements are available and offer a good alternative in older patients where demands are less and functional recovery is rapid. For higher demand patients, Artelon is a newer option. It consists of a polyurethane urea material that allows for an interposition arthroplasty serving as a cushion for he joint to provide pain relief.  If failure should occur, the implant can be excised and the remainder of the trapezium removed. Because the procedure requires only millimeters of trapezial bone excision, the underlying biomechan­ics of the thumb are maintained. In certain scenarios, the implant may even be inserted arthroscopically (through a small fiberoptic camera) and provide a more minimally invasive procedure that accomplishes the same goals.  Cur­rently I prefer this method of treatment for advanced basal joint arthritis in younger or active individuals, regardless of age. Arthroscopy for thumb pain (Basal Joint Arthritis) The role of arthroscopy may be most beneficial in the early stages of basal joint arthritis. The earliest presenta­tion of this painful condition has few surgical options once conservative treatment has been exhausted. It is apparent  that a young, active woman may not agree to a complete  open removal of a wrist bone even when her symptoms are persistent. The other surgical options discussed are also relatively aggressive for the young, active patient. There­fore, failed conservative treatment of thumb basal joint ar­thritis in these patients remains a dilemma. However, there is now a very good alternative in arthroscopy. The patient who remains symptomatic despite several cortisone injections and splinting may very well welcome a minimally invasive procedure. Hence, arthroscopy allows doctors to treat much earlier stages of this condition in a less painful manner while giving us a true image of the joint involvement. he same advantages that we have seen in the treat­ment of large joints, such as knee and shoulder, are present in this joint. However, the full role of arthroscopy in the treatment of thumb arthritis remains to be seen. As people live longer and become increasingly more active, it will be crucial to provide better options for the painful arthritic thumb. New advances in small joint. arthroscopic procedures or in biomaterials will lead to greater treatment options at this vital small joint. Removal of a supporting bone or fusion of this mobile joint may contin­ue to have a place in surgical treatment, butI suspect that over time these treatments will become only of historical  significance. Dr. Alejandro Badia Whats causing your thumb pain? Whats causing your thumb pain? El uso de móvil y consolas provoca daños al pulgar? El uso de móvil y consolas provoca daños

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Categoría: Pulgar

Nuevo herald portada
Artículos de Pacientes

Reemplazo de la articulación del pulgar (artritis del pulgar)

Novedoso reemplazó de la articulacion del pulgar El ortopedista Alejandro Badia reemplaza la articulación de la la base del pulga, afectada por la artritis, por una de titaniumPublicado por El Nuevo Herald 2010 Click aqui para ver el procedimiento en Español Click aqui para ver el procedimiento en Ingles Reemplazo de la articulación del pulgar (artritis del pulgar) Reemplazo de la articulación del pulgar (artritis del pulgar) Options for Treating a Painful, Arthritic Thumb Options for Treating a Painful, Arthritic Thumb Whats causing your thumb pain? Whats causing your thumb pain? Want to see more articles? BHS Blog Scientific Publications

Leer Más "
atroscopia pequeña articulación pulgar
Artículos de Pacientes

Opciones para tratar la artritis del pulgar

Treatment Options for a Painful, Arthritic Thumb Health News Digest 2020 Pain relief is more available than ever for treating a painful arthritic thumb, thanks to the development of ever-newer technologies, says Miami-based orthopedic surgeon Alejandro Badia MD.  Dr. Badia, a noted specialist in disorders and injuries of the hand, wrist and upper limbs, is using the BioPro® Modular Thumb Implant as an effective alternative for relieving osteoarthritis of the joint at the base of the thumb – the basal joint. He says such advances in biomaterials could supersede what has been, until now, the gold standard” for surgical treatment – LRTI. LRTI, normally performed as an outpatient procedure, involves removal of the thumb joint’s trapezium (carpal bone) and then a transfer of a tendon from the patient’s forearm to the trapezial space to stabilize the area and prevent collapse of the joint. Although experts contend LRTI provides “95 percent pain relief” and up to 80 percent return of gripping strength, the surgery has some major drawbacks. “Removing the trapezium may shorten the thumb and leave patients few other options if symptoms persist,” Dr. Badia states. He adds that recovery from this kind of surgery also can be prolonged and painful. Thumb ligament reconstruction without excising the arthritic bone may prove helpful if a patient only experiences a loose tendon, but no loss of bone cartilage, due to disease, Dr. Badia says.Another common approach is basal joint fusion or arthrodesis which has its cons as well. It is usually limited to a patient’s non-dominant hand because the surgery is “associated with decreased range of motion,” transfer of normal forces in the thumb to other hand joints and a lack of complete fusion of bone at the thumb’s base, according to authors of a 2017 report in Orthopedic Reviews. “Another option is arthroscopic reconstruction which I tend to use in younger, higher demand patients and when alternatives to surgery are sought. The use of Protease Inhibitors (like PRP on steroids!!) has shown promising results in early follow up of patients with this new modality of treatment,” Dr. Badia says. As the population ages but continues to be increasingly active, more effective approaches will be needed to provide pain relief from this debilitating osteoarthritic condition, while maintaining strength and range of motion in the thumb,” says Dr. Badia, founder and chief medical officer of the Badia Hand to Shoulder Center and OrthoNOW®, a walk-in orthopedic care clinic. Dr. Badia calls advances in artificial joint implants like the BioPro® a “step in the right direction.” Other scientists concur. For example, in a February 2019 Journal of Hand Surgery (European Volume), authors write that, in a four-year follow-up, patients who received an advanced thumb-joint prosthesis – in this case, an Ivory® implant – experienced “significantly better thumb abduction, adduction, grip strength, pain relief, satisfaction and faster return to daily activities and previous work” than those who had undergone LRTI. The study included nearly 150 patients.“Advancements in implant design and materials are overcoming the tendencies of older prosthetic versions to fracture, dislocate or simply fail to relieve pain and improve thumb function,” Dr. Badia explains. Arthroplasty of the thumb is much like a total knee or hip replacement. All or part of the thumb joint is removed and replaced with a prosthesis. Dr. Badia Associated with aging or previous thumb injury, osteoarthritis of the basal joint is the second most common arthritic condition of the hand, affecting approximately 15 percent of those above 30 years of age and about a third of postmenopausal women. The disorder, which leads to collagen loss and, in its later stages, bony overgrowths on the trapezium, can result in severe pain and loss of grip function and strength.  Physicians normally pursue conservative treatment approaches for patients in early stages of thumb arthritis, including use of anti-inflammatory medications, injection of corticosteroids, thumb splinting, and physical therapy. However, “these treatments are unable to alter the inevitable course of the disease’s progressive pain — and even thumb deformity — leaving only surgery as next line of defense,” Dr. Badia says. “Main advantage of total joint surgery is that no bridges have been burned,” Dr. Badia adds. “If a patient’s symptoms persist, the thumb implant can be readily removed, and another surgical procedure performed.”  Facebook Twitter LinkedIn Email Arthroscopic Options for Treating a Painful, Arthritic Thumb Arthroscopic Options for Treating a Painful, Arthritic Thumb Whats causing your thumb pain? Whats causing your thumb pain? El uso de móvil y consolas provoca daños al pulgar? El uso de móvil y consolas provoca daños al pulgar? Want to see more articles? BHS Blog Patient Articles

Leer Más "
dolor en el pulgar
Artículos de Pacientes

¿Cuál es la causa de su dolor en el pulgar?

Whats causing your thumb pain? Anti-inflammatories, splinting, or even corticosteroid injections simply diminish symptoms but do not provide a long-term solution. Anti-inflammatories, splinting, or even corticosteroid injections do not alter the often inevitable course of progressive pain and even deformity. What is osteoarthritis ? Most typically basal joint arthritis, is the second most common location for arthritis in the hand but the most functionally disabling. The func­tion of thumb opposition and subsequent pinch are crucial for such daily activities as turning a key, opening a jar, or picking a small object off the table, No wonder pain and weakness from the base of the thumb is so functionally disabling! Conservative treatment for Basal Joint Arthritis: The initial treatment of symptomatic basal joint ar­thritis is most often for pain relief. Anti-inflammatories, splinting, or even corticosteroid injections simply diminish symptoms but do not provide a long-term solution. They do not alter the often inevitable course of progressive pain and even deformity. Therapy can play a role in conservative treatment, but in severe cases it can actually aggravate symptoms. A wide variety of splints are available that allow the joint to rest and may minimize the pain, but the very fact that  motion of this joint is important for hand function underscores the need for something other than splinting. Nonsterodial anti-inflammatories (ibuprofen/ Naproxen/Cox-2 inhibitors) have only a temporary effect and are used simply for marginal symptomatic relief. The gastric complications of using these drugs should not be overlooked and patients should not use them long-term when seeking relief from simply one joint in the hand. Injections for thumb pain? Corticosteroid injections have a more prolonged effect but can have long-term deleterious effects on the joint cartilage or capsule. Persistent pain demands that something more definitive be instituted for treatment;. and for this reason, sur­gery has generally been the most effec­tive treatment in symptomatic .cases. Surgical Option: LRTI The problem is that until recently, there have been few surgical options, and those were often quite pain­ful and required a prolonged recovery. One of the earliest surgical treatments was complete excision of the trapezium, a small bone at the base of the thumb within the wrist. This simple operation was first de­scribed over 50 years ago. A more complex version of this procedure is termed the LRTI (ligament reconstruction tendon  interposition) and has become the most common­ly used surgical procedure for treatment of painful basal joint arthritis’.  This relatively complex operation combines several previously described procedures including the complete removal of the trapezium bone and the stabilization of the metacarpal base using a strip of a wrist tendon. While reports in the hand surgery literature are generally favorable in terms of the outcome, several problems remain with this operation. One of them is that the recovery. process is relatively long and can be painful. However, the main problem lies in the fact that there are few salvage op­tions if painful symptoms persist because the trapezium has been completely removed. Once this bone, the pillar base of the thumb, is removed, there are few remedies  available to reconstruct the thumb should the need arise. Similar problems occur after fusion, which eliminates motion because the adjacent joints, which are frequently ar­thritic as well, can become symptomatic. Reversing a fu­sion is a formidable task and joint replacement maybe the only option. Learn more about thumb joint replacements Thumb joint replacement Like in , so many other joints, metal/polyethylene joint replacements are available and offer a good alternative in older patients where demands are less and functional recovery is rapid. For higher demand patients, Artelon is a newer option. It consists of a polyurethane urea material that allows for an interposition arthroplasty serving as a cushion for he joint to provide pain relief.  If failure should occur, the implant can be excised and the remainder of the trapezium removed. Because the procedure requires only millimeters of trapezial bone excision, the underlying biomechan­ics of the thumb are maintained. In certain scenarios, the implant may even be inserted arthroscopically (through a small fiberoptic camera) and provide a more minimally invasive procedure that accomplishes the same goals.  Cur­rently I prefer this method of treatment for advanced basal joint arthritis in younger or active individuals, regardless of age. Arthroscopy for thumb pain (Basal Joint Arthritis) The role of arthroscopy may be most beneficial in the early stages of basal joint arthritis. The earliest presenta­tion of this painful condition has few surgical options once conservative treatment has been exhausted. It is apparent  that a young, active woman may not agree to a complete  open removal of a wrist bone even when her symptoms are persistent. The other surgical options discussed are also relatively aggressive for the young, active patient. There­fore, failed conservative treatment of thumb basal joint ar­thritis in these patients remains a dilemma. However, there is now a very good alternative in arthroscopy. The patient who remains symptomatic despite several cortisone injections and splinting may very well welcome a minimally invasive procedure. Hence, arthroscopy allows doctors to treat much earlier stages of this condition in a less painful manner while giving us a true image of the joint involvement. he same advantages that we have seen in the treat­ment of large joints, such as knee and shoulder, are present in this joint. However, the full role of arthroscopy in the treatment of thumb arthritis remains to be seen. As people live longer and become increasingly more active, it will be crucial to provide better options for the painful arthritic thumb. New advances in small joint. arthroscopic procedures or in biomaterials will lead to greater treatment options at this vital small joint. Removal of a supporting bone or fusion of this mobile joint may contin­ue to have a place in surgical treatment, butI suspect that over time these treatments will become only of historical  significance. Dr. Alejandro Badia Whats causing your thumb pain? Whats causing your thumb pain? El uso de móvil y consolas provoca daños al pulgar? El uso de móvil y consolas provoca daños

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