Your Guide to Arthritis Surgery

Many people can manage their arthritis symptoms through exercise, diet and treatment. However, sometimes the challenges of living with the disease require surgery to help with pain, reduced mobility and decreased quality of life. Not surprisingly, surgery can be seen with a complex mixture of concern (How long will my recovery be? What if the surgery doesn’t work?) and anticipation (I can’t wait to have less pain and be able to move around better!). There are a number of different kinds of surgeries to treat arthritis, often depending on your age, level of mobility and the joint affected. Read on to get an overview of the most common arthritis surgeries.

Total Joint Replacement (TJR)

Designed for people with severe joint pain, this is a replacement of the damaged natural joint with an implant made of metal, plastic, ceramic or a combination of those materials. This surgery has a good track record for success, meaning that pain is reduced and mobility is increased. The main drawback is that while implants last 20 years or longer, all joints will eventually wear out, and you may require joint revision surgery to replace the artificial joint. To learn more about two of the most common types of total joint replacement surgery, visit the Arthritis Society’s resources on Hip Replacement Surgery and Knee Replacement Surgery.  Another type of this surgery is called Minimally Invasive TJR, which uses shorter incisions and decreases recovery time, but can have a higher rate of complications.

Joint Revision

If a joint replacement fails, becomes infected or becomes worn out, it can be replaced through joint revision surgery. This can help with pain, strength and mobility, but is also considered to be at higher risk for complications, because of the way the surgeon altered the bones during the original TJR surgery. A bone graft (taking bone from another part of the body) may be also required.

Partial Knee or Hip Replacement

Also called joint resurfacing, this surgery means that the doctor uses an implant to only replace one of the three parts, or compartments, in the knee, relieving pain and increasing day-to-day mobility. It may be recommended if you are older, less active and have arthritis only in one knee compartment. If it’s performed on the hip joint, the hip socket is replaced and the hip ball (that fits into the socket) is reshaped and covered with a prosthetic cap. Partial hip replacement may be best for men under 60, especially if you have a physically demanding job, and can mean that you are still able to participate in high-impact activities. The drawbacks for both: there are higher complication rates.

Arthroscopy

This technique is most often used with active people under the age of 40. A surgeon uses small incisions and a miniature camera to repair or remove damaged cartilage or repair tears in soft tissues around joints. This approach often reduces pain and improves range of motion, but may not stop further deterioration of the joint.

Osteotomy

This specialized surgery means that a surgeon cuts and removes bone, or adds bone, near a damaged joint, in order to shift weight from an area damaged by arthritis or to correct misalignment. It may postpone a joint replacement, and so is most often used in patients aged 30 and younger.

Arthrodesis

Also referred to as fusion, this is a procedure where the surgeon uses hardware including pins, rods and plates to join two or more joints, creating one continuous joint. Eventually, the bones grow together and fuse the joint in place. It’s performed on the spine, fingers, wrists, ankles or thumbs, and is for people with osteoarthritis or inflammatory arthritis that has caused severe joint damage. The fused joint is strong—strong enough to accommodate high-impact activity—and should last a lifetime. However, it does reduce flexibility and range of motion. Fusion can also stress surrounding joints, possibly creating arthritis in other joints.

Synovectomy

The lining of the joints is called the synovium. If it becomes inflamed or grows too much due to inflammatory arthritis, it damages the cartilage and joints, so a surgeon will remove the affected lining. This is done through either arthroscopy or open surgery. The goal is to improve function and decrease pain, but those results may be only temporary. The procedure may also limit range of motion.

The thought of surgery can be daunting, but it can sometimes be your best option to improve your quality of life. Talk to your arthritis care team to understand the pros and cons and see if surgery is the right option for you.
 
For more information, visit the Surgery section of the Arthritis Society website.

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