Date :28-Jun-2023
Consider the inconvenience of swollen, misshapen fingers or painful knee joints. Picture a situation in which your life is dictated by the amount of pain you experience every day. Consider changing your entire lifestyle or relearning your daily chores to accommodate your pain. This was Disha's (name changed) reality since she was diagnosed with rheumatoid arthritis at the age of 23.
Dr. Bharani Kumar Dayanandam, the senior orthopaedic surgeon and trauma consultant at Chennai Orthopaedics, discusses the case of Disha, who had to have surgery to repair her rheumatoid arthritis-damaged joints.
Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakes host cells for invaders. “The main course of action that the immune system takes to remove these misidentified cells is to cause inflammation. As a result, a person suffering from rheumatoid arthritis will experience pain, redness, swelling, and other symptoms of inflammation. Since the tissues surrounding the joint are the target of the immune attack in rheumatoid arthritis, the pain and inflammation will be concentrated in the finger joints, knees, wrists, elbows, and so on," explains Dr. Bharani Kumar.
"Rheumatoid arthritis is a disease for which there is no cure. The only treatments available are aimed at relieving symptoms and assisting the patient in living as comfortably as possible," Dr. Bharani Kumar says. Drugs and physical therapy are the most commonly used treatment options. Pain relievers, steroids, nonsteroidal anti-inflammatory drugs (NSAIDs), and disease-modifying anti-rheumatic drugs (DMARDs) are among the medications available. Depending on the severity and progression of the condition, different combinations of these drugs are prescribed.
However, in some advanced cases of rheumatoid arthritis, surgery might be necessary to relieve the pain, stabilize the joints, and improve the quality of life. Disha was one such patient who required surgery in order to improve her life and live it to the fullest. “When Disha approached me, her knee joints and finger joints were swollen and she was in a lot of pain. Since she had been on various medications for more than 15 years and was still suffering, the best option for her was to have a knee replacement surgery,” says Dr. Bharani Kumar.
Arthrodesis and synovectomy are two other surgical options for people with severe rheumatoid arthritis. Arthrodesis is a joint fusion surgery that relieves rheumatoid arthritis pain. However, because it completely removes the joint, it may limit the range of motion. Synovectomy, on the other hand, involves the removal of the inflamed synovium (the membrane that surrounds the joint). The disadvantage of this procedure is that the symptoms may reoccur because complete removal of the tissue is not always possible.
“Dr. Bharani Kumar explained all the pros and cons of getting a knee replacement surgery at such young age. I was aware that I might need another knee replacement surgery after 15 or 20 years. However, the thought of being able to live a pain-free life for that long, pushed me to go for the surgery,” says Disha.
Disha continues to fight her daily battle against rheumatoid arthritis. She continues to take her medication to keep the dreaded disease and its symptoms at bay. However, she is now able to walk, thanks to Dr. Bharani Kumar and the incredible job he has done relacing her knee. “Surgery is only used as a last resort in the treatment of rheumatoid arthritis. I only recommend surgery when all other options have been exhausted and the patient is no longer responding to medications,” says Dr. Bharani Kumar.
