A doctor may recommend surgery for rheumatoid arthritis if you have severe joint damage or pain. Joint replacement, joint fusion, and tendon repair are among your options.
Rheumatoid arthritis is an autoimmune condition in which your immune system attacks healthy cells in your joints. This can lead to pain, stiffness, and swelling in the joints.
Doctors generally first try treating rheumatoid arthritis with oral medications, biologics (products made from biological sources such as proteins, cells, or tissues), and injections before trying surgery. The most effective type of surgery depends on factors such as:
- the extent of your symptoms
- your affected joint
- your age and overall health
This article covers the most common types of surgery used to treat rheumatoid arthritis.
Surgery is the last resort treatment for rheumatoid arthritis, but many types of surgery are available.
The best type of surgery depends on factors such as which joint is causing you pain. Rheumatoid arthritis
Joint deformity is most commonly seen in the feet, and half of people with rheumatoid arthritis have foot problems within
The following surgeries are available to help people with rheumatoid arthritis manage their symptoms.
Synovectomy
A synovectomy involves removing the inflamed lining of your joint to reduce your pain and improve your mobility. The procedure can often be performed with an arthroscope, a long flexible tube that allows doctors to perform surgery using a much smaller incision than would otherwise be possible.
Synovectomy is no longer commonly used due to the development of
An alternative option that’s likely available only at academic centers is radiosynovectomy, which involves injecting small radioactive particles into your joint.
Tendon surgeries
A tendon repair surgery fixes a tendon that may have become damaged due to chronic inflammation. Your surgeon may surgically release tight tendons or transfer tendons from other parts of your body.
The
A tenosynovectomy involves removing an inflamed tendon sheath surrounding one of your tendons, usually in your
Osteotomy
Osteotomy is a bone-cutting surgery to realign weight bearing bones to correct deformities or misalignment, often in the
Partial knee replacement
A partial knee replacement involves replacing some of the structures in your knee with a synthetic implant. It traditionally hasn’t been performed very often for rheumatoid arthritis due to the fear that the disease could continue to progress.
Some newer evidence suggests that a partial knee replacement may be suitable for some people with rheumatoid arthritis.
Total joint replacement
A total joint replacement involves replacing your entire joint with a prosthetic. It can be performed on many different joints, such as your:
- hip
- knee
- shoulder
- wrist
Success rates for total joint replacement are generally very high. For example, an older
Joint fusion
Joint fusion surgery involves permanently fusing two bones in your joint. You won’t be able to move your joint after the surgery. It may be performed on joints such as your ankles, fingers, or spine.
Joint fusion is the most common surgery for rheumatoid arthritis, and it’s primarily performed on the ankle, the foot, or both. Joint replacement of the ankle joint, in particular, allows for the preservation of your range of motion and, thus, a more stable gait.
The
Joint surgery can cause many different risks, such as:
- delayed wound healing
- infection
- blood clots
- problems with an implant
- bleeding
- reaction to anesthesia
- nerve damage
- chronic pain
Studies consistently suggest that people with rheumatoid arthritis have higher rates of postsurgical side effects than people without rheumatoid arthritis.
Here are some questions you may want to ask your doctor before undergoing surgery:
- What are the advantages of surgery over more conservative options?
- What type of surgery is best for me?
- What are the potential risks of surgery?
- What are the chances of success?
- What is the typical outcome for people who receive this surgery?
Your preparation will vary depending on which type of surgery you need. Most types of joint surgery are performed under general anesthesia. You’ll need to stop eating and drinking hours before your procedure. Your surgery team can tell you exactly how long in advance you need to fast.
You also may be told to stop taking medications or supplements that can thin your blood to reduce your risk of bleeding.
Your recovery time depends on which type of surgery you receive and which joint is treated. Larger joints often take longer to heal than smaller joints. Surgery on your feet or ankles is often more disruptive to your life than surgery on your upper limbs.
Following finger fusion surgery, most people can start driving after about 8 to 10 weeks. They can also return to work and sports within 10 to 12 weeks.
Joint replacement surgeries are major operations that usually require multiple nights in a hospital and months of rehabilitation.
Surgery is generally considered the
Surgery helps many people relieve pain and improve their mobility, although the outcome can vary significantly between people.
Prosthetics used in total joint replacements can often improve your quality of life and generally last 10 to 20 years. You’ll need another surgery if your artificial joint wears out.
Many types of surgery are available to treat rheumatoid arthritis. The best type of surgery for you depends on factors such as the location of your symptoms and the extent of your disease.
Many people experience improvements in their pain after surgery. Like all procedures, surgery to treat rheumatoid arthritis does come with risks.