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Osteoarthritis in Hands: Overview

Osteoarthritis, also known as “wear and tear” arthritis, is an inflammatory condition that causes the deterioration of the cartilage located between the joint’s bones. The cartilage plays a vital role in providing a “cushioning” effect, thus preventing bones and other components (like ligaments and tendons) from being damaged by friction and shock during movements.

If you have hand osteoarthritis, the cartilage will wear down over time, and the bones will begin to rub against each other every time you move your hands. This causes chronic pain, inflammation, swelling, reduced mobility, and visible deformities.

Some of the main risk factors for OA include:

  • Age-related deterioration 
  • Genetic and inherited factors, such as thinner cartilage or dysfunction of the genes responsible for forming the cartilage
  • Being female, because the joints are less stable, thus leading to increased friction during movement.
  • Hand trauma and injuries, such as dislocations
  • Overuse and excessive stress (such as performing repetitive hand movements at work or when playing sports)

It is estimated that up to 65% of cases of OA have a genetic component, and that nearly half of women will develop this condition.

Symptoms of Osteoarthritis in Hands

Hand OA may occur in any joint in the hand, but it usually affects the middle joint of the fingers, the joint closer to the fingertips, and the joint that connects the wrist with the base of the thumb.

The symptoms you’ll experience may be localized around the area affected by OA at first. However, over time, the inability to properly move your hand can lead to overall disability, sleep problems, inhibited physical intimacy, and mental health issues. What’s more, without treatment, the symptoms of hand OA will continue to worsen and grow in intensity over time.

Some of the early signs of hand OA you should watch out for include:

  • Hand joint pain that intensifies after activity or exercise
  • Joint stiffness, especially after periods of rest
  • Reduced range of movement
  • Clicking and popping sounds in the joints (also known as crepitus)
  • Pain, which may be occasional at first, but becomes severe and chronic over time
  • Swelling 
  • Stiffness
  • Joint instability (a sensation that your hand will “give out”)
  • Reduced grip strength

Nearly 60% of people with hand arthritis will also develop hand deformities. Bony lumps and abnormal bone growth occur when the body attempts to repair the damage caused by the deterioration of cartilage growing new hard tissue (bone). Deformities can further impair your ability to move and use your hands, leading to increased pain and disability.

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Conventional Treatment Options

Osteoarthritis in the hands is a lifelong condition that may continue to worsen over time. To make things worse is the fact that, often, patients are offered limited treatments, which don’t do much more than simply ease pain and make the symptoms more manageable. However, these treatments are inefficient in improving hand function or preventing the disease from progressing.

Some of the most common treatments offered today include the following ones.

Corticosteroid injections

Corticosteroids are the synthetic version of cortisol, a hormone naturally produced by the body to inhibit pain signals and inflammation. Corticosteroids, which are usually delivered by injection into the painful area, release pain-killing chemicals over time, thus providing longer-lasting relief from pain.

However, when used chronically, this class of medication causes significant side effects, including mood swings, muscle weakness, and high blood pressure. Repeated injections can also speed up cartilage loss.


Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that relieve pain by blocking the cyclooxygenase (COX) enzyme. These enzymes are responsible for making prostaglandins, which are chemicals that amplify pain signals and cause tissue swelling. By reducing the production of prostaglandins, NSAIDs are able to provide temporary relief from pain.

These medications, which include ibuprofen, naproxen, and aspirin, are typically available as an over-the-counter alternative, making them a popular choice to manage pain. However, when taken chronically, NSAIDs can lead to side effects that should not be overlooked, including increased risk of stroke and heart attack, stomach ulcers, kidney dysfunction, and addiction.

Knuckle Replacement (Arthroplasty)

As hand osteoarthritis progresses, it can cause permanent damage to the bones, ligaments, and tendons in the hand. When these injuries become irremediable, surgery may help restore hand function partially.

One of the most common forms of surgical interventions for hand OA is arthroplasty, or knuckle replacement. Depending on the extent of the damage, arthroplasty can be used to restore a part of the knuckle (partial replacement) or the entire joint (total replacement).

During this surgical intervention, a surgeon will remove the damaged parts of the joint, reshape bones, and replace tissues (such as bones) with synthetic implants, which are usually made of plastic or metal. This type of surgery isn’t always able to restore finger motion, and it comes with extensive recovery periods and risks.

Fusion (Arthrodesis)

Another type of surgery used in severe cases of hand OA is arthrodesis, or fusion. In this surgical operation, two of the hand or finger bones are fused together. This reduces mobility, which eases friction, pain, and stress on already damaged bones. However, it significantly limits the mobility and flexibility of the hand.

What is Platelet-Rich Plasma, or PRP?

PRP – which stands for Platelet Rich Plasma – is the technical name for samples of the patient’s blood, which are processed and purified to increase the concentrations of platelets in the plasma. The platelets are tiny components of the blood, which are responsible for clotting, stopping bleeding, and healing wounds.

Platelets also boast high concentrations of growth factors. Growth factors, which in platelets are contained in “packets” called alpha granulate, promote the activity of repair cells (including stem cells), and are able to call to action repair cells from across the body to the site of injury. For ease of visualization, you can think of growth factors as “espresso shots” that amplify the healing power of repair cells.

When concentrated, PRP contains far higher concentrations of platelets – and, in turn, of growth factors – compared to “normal” blood.


PRP for Osteoarthritis in Hands

Platelet Rich Plasma is a form of regenerative medicine that uses high concentrations of the blood’s healing factors to enhance the body’s ability to repair itself. In regenerative orthopedics, this treatment can be used to treat muscle strains, tendon or ligament tears, and joint instability. To this day, there have been more than 30 randomized trials showing the ability of PRP to help the body heal itself by stimulating the stem cells located around the injured area.

In the treatment of hand osteoarthritis, this therapy works by supporting the regeneration of damaged cartilage, repairing injured bones and other tissues, and preventing further degeneration.

Among others, three studies – conducted, respectively, in 2020, 2021, and 2023 – show that PRP can reduce pain and boost hand function, offer better pain relief than corticosteroids, and improve symptoms by over 68%. While research is still ongoing, these studies alone show the promising outcomes of the use of PRP in the treatment of hand OA.


Why are Orthagenex PRP Injections Superior?

At Orthagenex, treatment outcome and full patient satisfaction are the number one priority. To achieve this, we have pioneered a superior PRP injection procedure, Super Concentrated Platelets (SCP).

SCP uses image guidance to enhance precision and ad hoc laboratory settings to produce hyper-concentrated PRP. This guarantees that each injection is far purer, more concentrated, and more customizable to each patient’s needs. 

Here is what makes SCP different:

Image-Guidance to Place PRP Solutions

Most orthopedic practices offering PRP therapies today perform injections blindly, without image guidance. Even in the cases where some type of image guidance is used, physicians often lack the necessary training to interpret results. According to research, this can lead to physicians missing the target location 20-40% of the time.

That’s where the Orthagenex procedures stand out. Our PRP injections are created and performed by a team of specialized physicians. The procedure is carried out using ultrasound guidance and fluoroscopy:

  • Ultrasound guidance: Ultrasound guidance offers a real-time visual aid of the position of the needle from the moment it enters the skin, thus reducing reliance on tactile sensations and guaranteeing needle placement accuracy.
  • Fluoroscopy: Fluoroscopy is a type of X-ray that allows physicians to obtain X-ray images in real-time during PRP injections.

Using these techniques in combination, our specialists are able to precisely deliver concentrations of platelets and growth factors to the site of injury.

The use of imaging guidance in PRP is today known as Interventional Orthopedics. This is a a new medical specialty based on three key pillars:

  • The use of injectates to promote the healing of musculoskeletal tissues; 
  • The use of imaging guidance to ensure the precise placement of injectates;
  • And, the future development of new tools and techniques to improve outcomes.

Lab-Processed for Higher Concentrations of Platelets

Orthagenex is able to offer each patient entirely customizable and super-concentrated PRP injections thanks to a special lab platform. To clarify how this makes a difference, let’s look at how most other orthopedic clinics in the US create PRP.

Typically, PRP is created in a simple centrifuge machine, bedside. After the blood sample is collected, it is placed inside the centrifuge which, spinning, separates the platelets from other blood components. The resulting injectate is then immediately delivered to the site of injury.

These automated machines are not as efficient as expected in concentrating platelets, and they are often unable to entirely separate impurities and unfavorable cells from the resulting mixture.

Oppositely, at Orthagenex, Super Concentrated Platelets are created using a dedicated lab platform. After being collected from the patient, the blood samples are delivered to state-of-the-art cellular lab environments located within the Orthagenex clinic. Here, the platelets are concentrated using specialized machinery, and unfavorable components are efficiently removed.

  • Concentration of platelets: Super Concentrated Platelets vs. standard bedside machines

Higher platelet concentrations and low levels of impurities translate into better outcomes. Standard bedside centrifuges are able to offer platelet concentrations as high as 2-5 times higher than baseline values, but, often, results are closer to 2-3 times. 

Oppositely, the Super Concentrated Platelets protocol is able to yield average concentrations 10-20 times higher than the ones found in “normal blood”. These concentrations can be as high as 30 times baseline values.

 Amber PRP vs. Red PRP

PRP comes in two main forms:

  • Red PRP: Red PRP (leukocyte rich PRP or LR-PRP) contains concentrations of white and red blood cells, as well as concentrations of platelets. 
  • Amber PRP: Amber PRP (leukocyte-poor PRP or LP-PRP) contains low levels of white and red blood cells. 

While both mixtures have high concentrations of platelets, the outcomes they offer are dissimilar. 

According to lab tests conducted by Orthagenex, standard centrifuges used to create PRP produce red PRP. The presence of white and red blood cells in this mixture can have an inhibiting action on the same stem cells that PRP is trying to stimulate, thus leading to a mitigating effect. Less pure injections have also been seen to cause inflammation after the procedure. 

Amber LP-PRP, on the other hand, is purer, is not pro-inflammatory, and ultimately has a more stimulating effect on the cartilage cells. Given the better healing outcomes of Amber LP-PRP, this is the injectate of choice at Orthagenex.

Next-Generation Platelet Lysate

Platelet lysate (PL) injections are a more advanced form of PRP. At Orthagnex, they are sometimes used in combination with or instead of Platelet Rich Plasma. 

Here are the differences between the two procedures:

Growth factors are released over time to the site of injury (up to a week). Growth factors are released immediately and en masse to the site of injury.
May cause some degree of inflammation to the site of injection. It is anti-inflammatory, does not cause inflammation.
May not be as suitable to treat sensitive areas. May not be as suitable to treat sensitive areas.

Unlike standard orthopedic clinics, which are just starting to learn about and introduce PL, the team at Orthagenex is already taking advantage of the third and fourth generation of PL injections.

PRP Customized To Every Patient’s Need

Although hand osteoarthritis is extremely widespread, no two people will report the same damage to joints – nor will they experience the same impact or disability. In turn, a single, standardized treatment is never recommended. 

That’s why, at Orthagenex, we take advantage of the latest innovations in regenerative medicine to offer entirely customized treatment programs. We do so using our Flexible Lab Platform, as well as by offering therapies like Bone Marrow Concentrate.

Solutions Are Customized Using A Lab Platform

Although the use of PRP is becoming widespread, it is important to understand that not all PRP injections are as efficient in delivering the expected outcomes.

In particular, most clinics use a one-size-fits-all approach and standard centrifuges to create PRP, which do little to provide patients with ad hoc treatments. At Orthagenex, we provide an alternative to this standard procedure by equipping our clinics with state-of-the-art cellular laboratories. Here, specialized technicians perform proprietary lab-processing techniques and create PRP mixtures with the right concentrations of platelets to treat hand osteoarthritis.

Bone Marrow Concentrate Can Be Used

Alongside PRP, Orthagenex offers Bone Marrow Concentrate (BMC).

BMC is a form of regenerative therapy that involves using imaging guidance to deliver concentrated bone marrow to injured or damaged areas. The liquid part of the bone marrow, which is extracted by creating a small tunnel into the bone, is remarkably rich in stem cells. These stem cells, when delivered to the areas in need, contribute to the healing of damaged tissues and support the body’s ability to regenerate injured bones, tendons, and ligaments.

Doctors Specializing in Interventional Orthopedics

To be able to deliver superior PRP treatments, Orthagenex uses advanced machinery – and relies on the knowledge and expertise of a team of specialists.

What sets Orthagenex apart?

  • All of Orthagenex physicians are musculoskeletal (MSK) specialists, experts in imaging guidance techniques. 
  • Our doctors are Board-Certified and Fellowship trained in Interventional Orthopedics.

Given that only 1% of US physicians are trained in Interventional Orthopedics, our clinics have been able to help more orthopedic patients than any other regenerative medicine clinic globally.

Core competencies

  • Using imaging guidance for precision 
  • Leveraging a Flexible Lab Platform to customize each PRP injection
  • Offering purer and more concentrated amber LP-PRP injections
  • Using a proprietary method of evaluation: the four-part SANS

SANS, which stands for stability, articulation, neuromuscular, and symmetry, is an innovative method for the evaluation and diagnosis of chronic pain. This approach allows the physicians at Orthagenex to precisely diagnose the location, nature, cause, and extent of pain and inflammation, so that patients can obtain a clear picture of their condition.

This is an essential stepping stone to design a treatment program that is safe, non-invasive, and efficient in delivering results.

Orthagenex – Your Alternative to Osteoarthritis in Hands Surgery

At Orthagenex, our mission is to provide each patient with a fully customized, safe, and efficient treatment program designed to meet specific goals and needs. 

Based on the principles of regenerative and interventional medicine, the superior PRP treatments designed at Orthagenex are able to help you regain your hand function and ease pain without surgery or medications. Above all, our next-generation PRP, PL, and BMC procedure will help support your body’s ability to repair damaged tissues and promote long-term health. 

The symptoms of hand osteoarthritis should not be considered a normal part of life. Regain your hand health and function with the Orthagenex approach.


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