Surgery

People with RA may benefit from the following surgical procedures:

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Joint replacement (arthroplasty). The most common type of arthroplasty is total joint replacement, in which the entire diseased or damaged joint is removed and replaced with a mechanical one to relieve pain and restore function. Resurfacing, also referred to as bone relining, is another type of joint replacement in which the damaged cartilage and bone ends in the hip joint are removed and capped with metal.

Arthroscopy. This entails the insertion of a thin, lighted tube with a camera attached to one end into a joint. It may be used diagnostically (to determine the type of arthritis or amount of damage) or therapeutically (to smooth roughened cartilage or flush out the joint to remove debris),

Arthrodesis. In this procedure, a surgeon fuses together two bones in a finger, wrist, ankle, or foot joint. While this operation results in a loss of flexibility, it relieves the pain caused by two bones rubbing against each other in a damaged joint.

Synovectomy. This procedure--performed mostly in people whose RA has not responded to medication--involves the removal of the inflamed synovial membrane in the elbow, shoulder, hip, or knee. Synovectomy is not as complicated a procedure as joint replacement, and it is not considered a permanent cure because the synovial membrane can grow back within several years. Medication is still required after synovectomy to reduce the chance that synovitis will recur.

Resection. In this procedure, all or part of a bone is removed from a joint in the hand, wrist, elbow, toe, or ankle. Resection is most commonly performed to relieve pain in people with RA. Recovery times vary but may be as long as several weeks.

Osteotomy. In this procedure a wedge of bone in the knee or spine is cut away and the remaining bones are realigned.