Medicine: Those Aching Joints

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First came surgery on her right knee, where the bones had grown together. The surgeons cut them apart and remolded the ends. To keep them from growing together again, they slipped in a layer of tissue from Angelina's own thigh. Such a knee joint is flexible but not very stable. To make sure that Angelina would not fall in a heap when she tried to walk, the surgeons cut through the bone of the left knee, straightened it, then let it heal in the extended position. They used traction and casts on her hips, made new joints for her elbows. Angelina's muscles, atrophied from disuse, were strengthened by exercises in the swimming pool (the buoyancy of water neutralizes the weight of the limbs and makes motion easier).

Last week Angelina was taking hesitant steps on her crutches. With a special long-handled comb she could do her own hair; with a tonglike device she pulled on her socks, and she scored a notable ADL victory when she worked a slip over her head. With a hand sewing machine (the exercise of working it is good for her), Angelina can almost be selfsupporting.

Despite the recent flurry of research advances, there is still no cure for rheumatoid arthritis—not in drugs, and certainly not in diet. But from judicious drug treatment and intensive aftercare, the unfortunate victim of this most damaging form of rheumatism can expect substantial early relief, and later, a fair recovery.