Drs. Waljee and Chung reply

To the Editor: We appreciate the opportunity to respond to the thoughtful comments of Drs. Momohara, Yano, Sakuma, and Ikari1 regarding our article examining variation in the rates of surgery for hand and wrist deformities caused by rheumatoid arthritis (RA)2. In this study, we examined the determinants of surgical reconstruction among older individuals with RA across the United States using population-based claims data. Overall, rates of surgical reconstruction are low, which is likely attributable to recent advances in the medical management of RA and the introduction of disease-modifying antirheumatic drugs (DMARD). Although rates of surgery did vary by patient factors, a substantial proportion … Address correspondence to Dr. J.F. Waljee, Section of Plastic Surgery, University of Michigan Health System, 2130 Taubman Center, SPC 5340, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109-5340, USA. E-mail: filip{at}med.umich.edu