Knee surgery in rheumatoid arthritis.
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Biomedical subjects
Publications and source records attributed to L Marmor.
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The first carpometacarpal (trapeziometacarpal) joints are a frequent site of osteoarthritis in postmenopausal women. This osteoarthritis, which is typically bilateral both clinically and roentgenographically, may be mistaken for tenosynovitis unless its characteristic features are recognized. These features include tenderness, stiffness, crepitus, swelling, and pain on wringing movements or other motions that cause abduction of the thumb. The swelling, radial subluxation of the metacarpal and atrophy of the thenar muscles give the hand a squared appearance.In severe cases, conservative medical therapy is generally unsatisfactory. Intra-articular corticosteroids and local anesthetic give only transient relief. Results of surgical therapy, including excision of the trapezium or arthrodesis of the trapeziometacarpal joint, were in general good. Distinct indications exist for each type of operation.
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One hundred and thirteen patients were treated in the orthopedic clinic of the University of California, Los Angeles, with 70 per cent dimethyl sulfoxide twice daily for a period averaging 7.2 weeks. Evaluation of the results revealed little if any therapeutic effect for patients with arthritis.