Arthritis is a group of diseases that cause swelling and pain in one or more joints.
There is more
Surgery can be an effective treatment for arthritis that doesn’t respond to more conservative treatments, such as rest and pain relief. Surgical options for arthritis range from minimally invasive procedures to total joint replacement.
Read on to learn about using surgery to treat arthritis, including the types, pros and cons, and recovery time.
In general, doctors recommend trying conservative treatments before considering surgery.
Common nonsurgical treatments for arthritis include:
If none of these treatments provide relief, you and your doctor can suggest the best next steps. Surgery may help improve the function of your joints, reduce pain, and prevent further joint damage. The decision to have arthritis surgery varies depending on your individual condition and other personal health factors.
Various types of surgeries are available to treat arthritis.
Which option is best for you depends on multiple factors, including:
- Which joints or joints are affected?
- How severe is your arthritis over your lifetime
- Your general health
- Your age
- Other personal risk factors
Let’s explore what the different procedures look like, and what the research says about their effectiveness.
The surgery is done endoscopically using an instrument called an arthroscope – a thin, flexible tube with a light on its end. Surgeons guide this instrument through a small incision to perform detailed work such as removing broken pieces of cartilage or repairing damaged ligaments.
In general, procedures performed with an arthroscope are less invasive than open surgery, require less anesthesia, and have a faster recovery.
However, arthroscopy is not an appropriate treatment for arthritis, and many doctors caution against it. For example, the Arthritis Foundation is actively discouraging arthroscopy for the treatment of osteoarthritis. Research shows that arthroscopy usually
Total joint replacement (TJR) replaces a damaged joint with an artificial implant made of metal, plastic or ceramic.
TJR is most often done on the knee or hip, but it can be done elsewhere.
Total knee replacement can reduce pain while improving quality of life and mobility. However, joint replacements eventually wear out and require joint revision surgery. For example, most knee joint implants should last at least 10 to 15 years. Revision surgery can be more expensive and complicated than original surgery.
The best candidates for total joint replacement are people who are in severe pain and have not found relief with less invasive treatments. Your doctor may recommend this procedure if you have
Recovering from a total joint replacement can be a lengthy process. According to the National Health Service, you should be able to stop using crutches or other supportive devices 6 weeks after a knee replacement. It may take 3 months for the pain and swelling to go away, and it may take up to a year for the swelling to go away completely.
A partial joint replacement replaces only part of your knee or hip instead of your entire joint. For the knee, the most common method that is performed is to remove the inner or outer space. For the hip, the joint cavity is replaced with a metal cup, and the joint ball is covered with a metal layer.
Partial knee replacements can help improve daily function. Partial hip replacements may allow you to participate in high-impact sports. The downside is that partial replacements tend to be difficult to perform and may have higher complication rates than full joint replacements.
According to the Arthritis Foundation, the best candidates for partial knee replacement are people who are less active with arthritis in one of the three parts of their knee. The best candidates for a partial hip replacement are men under the age of 50 with a large build, especially athletes and people with physically demanding jobs.
Partial joint replacement may not be suitable for people with smaller skeletons.
Returning to daily activities after the procedure takes about 3 to 6 weeks. Many people can return to sports such as golf within 6 to 10 weeks. Hip resurfacing usually causes pain and discomfort for several weeks after surgery, and you are likely to resume your normal activity after about 6 weeks.
Osteotomy involves cutting one or more of your bones, or adding a wedge near the damaged joint, to prevent further damage. For example, a knee osteotomy involves cutting and reshaping either the shin bone or the shinbone to relieve pressure on the joint.
According to the Arthritis Foundation, the best candidate is in their 30s and younger than is usually recommended for a total joint replacement.
Osteotomy can delay the need for a joint replacement by more than a decade. However, it is very complex and specialized.
In people with early-stage osteoarthritis, a knee osteotomy can be done on one side of the knee. Hip osteoarthritis may be recommended for young adults with isolated arthritis of a small portion of the hip. The procedure involves cutting the femur or pelvic bone to prevent further deterioration of the cartilage.
After your knee osteotomy, you may be able to resume normal activities after 3 to 6 months. After a hip osteotomy, it can take up to a year.
A synovectomy is a procedure that treats inflammatory forms of arthritis such as rheumatoid arthritis or psoriatic arthritis.
The most common type of joint in your body is called a synovial joint. These joints contain a fluid-filled joint cavity lined with a thin membrane called the synovium.
Synovial joints include:
In people with inflammatory arthritis, the synovium can become inflamed and cause damage to cartilage and other parts of the joints. A synovectomy removes most or all of the damaged synovium to relieve pain and improve joint function.
Candidates for synovectomy include people with inflammatory arthritis with minimal cartilage damage in the joint that has not responded to anti-inflammatory medications. A possible complication of the procedure is to restrict your range of motion.
The surgery has fewer complications when performed using an arthroscope compared to traditional incisions.
Recovery time depends on the joint you treated but it generally takes at least 3 weeks.
Joint fusion may be required if you have severe damage from osteoarthritis or inflammatory arthritis. During the procedure, the surgeon will use pins, plates, or rods to fuse two bones together so that you can no longer move your joint. Eventually, new bone tissue grows between the two bones.
This surgery can be performed on:
- finger bones
A knee or hip fusion is rarely done.
Joint fusion provides lasting results. The downside to this procedure is that it can change your range of motion and flexibility and lead to problems in other joints due to altered biomechanics. Fusing a joint such as the spine is a major operation. It is common for you to have to wait 6 months to a year before you can return to some activities.
Joint fusion is usually only done to treat severe arthritis pain. It was a more standard treatment for arthritis before joint replacement surgery was developed.
Revision joint surgery replaces a defective or damaged implant. A joint replacement usually lasts more than a decade before it needs to be replaced.
Factors that may lead to the need for early revision surgery include:
- Joint implant relief
- Exacerbation of joint problems
Revision surgery is highly variable based on your individual case. The procedure is often more complicated than the original procedure.
Recovering from a revision knee can take up to 12 months. Recovering from hip revision surgery can take anywhere from 12 to 18 months.
Every surgery comes with potential complications. It is important to talk to your doctor about the potential risks before opting for surgery so that you can weigh the pros and cons.
In some cases, the original surgery doesn’t cure the arthritis, and you’ll need a second procedure. If surgery or revision doesn’t work, you may have more pain or more limited range of motion than before.
If you receive a joint replacement, there is a small chance of problems with the implant itself. This can include mechanical malfunctions, or an inflammatory allergic reaction from the immune system.
Other potential complications of arthritis operations include:
For knee replacement surgery, complications occur in about 1 in 20 people.
Arthritis can cause severe pain and discomfort. Depending on the affected joints, you may experience serious impairment in your daily life and activities. Surgery is one option used to treat arthritis when other first-line treatments, such as physical therapy and pain relievers, aren’t effective.
Many types of surgery are used to repair or replace joints damaged by arthritis. Whether surgery is right for you depends on your specific condition and individual health factors. Talk to your doctor about the pros and cons of arthritis surgery, your options, and any concerns you have about complications.