Artificial Finger Joints: A Guide for Patients with Thyroid Issues

Artificial finger joints

Hello Dr.
Shi: My mother is 58 years old.
She had hyperthyroidism in her twenties and underwent treatment with radioactive iodine about 28 years ago.
This year, while visiting Taiwan, we took her to the hospital for a check-up and found that she has developed hypothyroidism.
Her fingers are severely deformed, swollen, and painful.
The doctor at the clinic took X-rays and said she needs finger joint replacement surgery.
I would like to ask Dr.
Shi if it is possible for my mother to undergo joint replacement surgery while she is currently taking ELTROXIN.
She is experiencing severe pain in her left ring and little fingers.
What would be the estimated cost for replacing both fingers without health insurance? Which hospital would you recommend for treatment?

Lei, 30~39 year old female. Ask Date: 2012/09/27

Dr. Shi Guozheng reply Orthopedics

It is possible to undergo surgery while taking medication.
However, without having seen the X-ray images, it is difficult to determine whether a finger joint replacement surgery is necessary.
Generally, for finger joints, a joint fusion procedure is often recommended as it tends to be more durable.
As for the cost, it is unclear, but it should not be significantly more than a typical total knee arthroplasty, which is approximately NT$130,000 covered by health insurance.

Reply Date: 2012/09/27

More Info

Understanding the need for artificial finger joints, especially in patients with thyroid issues, is crucial for both the patient and their family. Your mother's situation, where she has transitioned from hyperthyroidism to hypothyroidism, can significantly impact her overall health and the management of her musculoskeletal issues.

Thyroid hormones play a vital role in regulating metabolism, and their imbalance can lead to various complications, including musculoskeletal problems. In your mother's case, the history of hyperthyroidism followed by hypothyroidism may have contributed to the deterioration of her joint health, leading to deformities and pain in her fingers. The symptoms of swelling and pain, particularly in the context of her thyroid condition, suggest that her body is struggling to maintain proper joint function.

When it comes to the recommendation for artificial finger joints, it is essential to consider several factors:
1. Thyroid Management: Your mother is currently taking Eltroxin (levothyroxine), which is a synthetic form of the thyroid hormone used to treat hypothyroidism. It is crucial to ensure that her thyroid levels are well-managed before undergoing any surgical procedures. Uncontrolled thyroid levels can increase the risk of complications during and after surgery.

2. Surgical Considerations: The decision to proceed with joint replacement surgery should involve a thorough evaluation by an orthopedic surgeon who specializes in hand surgery. They will assess the extent of the deformity, the condition of the surrounding tissues, and her overall health status, including her thyroid function.
3. Cost and Insurance: You mentioned the absence of health insurance coverage for the procedure. The cost of artificial finger joint replacement can vary widely depending on the hospital, the complexity of the surgery, and the type of prosthetic used. In the United States, the cost for a single finger joint replacement can range from $10,000 to $20,000 or more. It is advisable to consult with the hospital's billing department for an estimate and to explore any financial assistance programs they may offer.

4. Choosing a Hospital: When selecting a hospital for this type of surgery, look for facilities that have a strong orthopedic department, particularly one that specializes in hand surgery. Research hospitals with good patient reviews and outcomes for similar procedures. It may also be beneficial to seek recommendations from her primary care physician or endocrinologist.

5. Post-Surgery Rehabilitation: After the surgery, rehabilitation will be crucial for recovery. Physical therapy will help regain strength and mobility in the fingers. It's essential to follow the rehabilitation plan closely to achieve the best possible outcomes.

In summary, while your mother's condition may necessitate the replacement of her finger joints, it is vital to ensure her thyroid levels are stable and to consult with a specialized orthopedic surgeon. The decision should be made collaboratively, considering her overall health, the potential risks, and the expected benefits of the surgery. Proper planning and management can lead to improved function and quality of life for your mother.

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