A 16 Year Journey in the Study of Rheumatoid Hand Disease.

Evidence-based medicine is a relatively new concept in hand surgery. A lack of high-level evidence often leads to uncertainty in the effectiveness of various procedures and regional variation in their use. Rheumatoid hand surgery has been plagued by a lack of quality data that has caused controversy between rheumatologists and hand surgeons. Research over the past 16 years has strived to provide data that can be used to provide evidence-based care for rheumatoid arthritis (RA) patients. The Silicone Arthroplasty in Rheumatoid Arthritis (SARA) Study is a prospective, long-term cohort study of RA patients with severe metacarpophalangeal joint deformity who have elected to undergo or to not undergo metacarpophalangeal joint arthroplasty. The SARA Study, funded for ten years by the National Institutes of Health, has provided invaluable results on the effectiveness of this procedure in terms of outcomes and cost, improving knowledge for both physicians and patients. (C)2017American Society of Plastic Surgeons

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