Medical therapies for rheumatoid arthritis have improved, reducing the need for surgical interventions for deformities.

“the medical therapy they're so amazing they have been absolute game changers and keep people normal for such a long time so that's one thing but in general I mean when I started practice I would see I would have to operate as often in a patient with rheumatoid arthritis and those deformities that happen and you're trying to beat them beat the body to addressing the deformities so they don't get bad enough to where they really require joint Replacements and much more complicated recoveries and so forth so it's always it was always a battle and kind of like you racing a car you know you're just trying to get get just a little bit ahead and just do whatever you can do to to win that and now I mean I would say I probably see maybe one a month okay that needs surgery and it's pretty rare”