Many thousands of Britons suffer from arthritis in the hands. Roy Carter, 69, a volunteer ambulance driver from Hampshire, became one of the first to have new knuckles made from material used in the NASA space shuttle. Here, Roy tells his story to Thea Jourdan, while his surgeon explains the procedure.

THE PATIENT

Before I retired nine years ago, I was a postman handling thousands of letters a day. But there came a time when I couldn’t pick up the post because my knuckles on my right hand were so painful. I was very sporty when I was younger and I played hockey in the London League, so my hands were always getting knocked. I went to the doctor who diagnosed osteoarthritis, possibly caused by old hockey injuries that had been made worse through overuse. I was told there wasn’t much that could be done, so I just took ibuprofen to reduce the inflammation. It was still extremely painful though and I had difficulty sleeping. I couldn’t even pick up a cup of tea without shooting pains going through my hand. My wife, Eileen, had to do up my buttons on my shirt and I couldn’t even get my own cornflakes in the morning. They would often end up all over the floor because I had no dexterity in my hands. I didn’t like needing constant help but I’m just not the kind of person to get depressed. My daughter, who is a physiotherapist, suggested I think about getting a knuckle replacement operation. It sounded a bit extreme, but by then I was desperate.

Three years after I first went to my GP about this problem, I went back and asked for a referral to a specialist hand surgeon who carried out this type of operation. I was booked into see Mr Warwick at Southampton University Hospital. When we met, he wanted to try to see if injections alone could cure the problem. So I had several injections of a corticosteroid to try and reduce the inflammation. Although these eased the symptoms, the problem didn’t go away. Mr Warwick then decided two knuckles in my right hand were suitable for replacement surgery. He explained he wanted to use a new type of replacement joint made from pyrocarbon — which they used for the nose of the NASA Space Shuttle. This material is very hard, but flexible like bone. Mr Warwick said the traditional type of joint used is very basic and tends to wear out quickly. Hopefully, with my new hardwearing implants, I would never need to have the operation repeated. We agreed he’d replace one knuckle at at time to see how I got on. I had the operation three months later. When I came round from the general anaesthetic, my hand was in a plaster. It was quite sore but I had some painkillers. I went home the next day wearing a special splint and had therapy on my hand for six weeks. I also did special exercises every day to strengthen my knuckle joints.

A year later, I went back to have my second knuckle replaced as it was increasingly painful. That operation was also a great success. Now, I have no pain at all. I volunteer as an ambulance driver four days a week and I have no problem gripping the steering wheel. There is only a little scar to show I had the operation, but inside I have space age knuckles. I’d recommend this to anyone in the same position I was — it has transformed my life. Click to see entire news story.