From healthline.com
Arthritis is a group of diseases that cause swelling and tenderness in one or more joints.
There are over 100 types
Surgery can be an effective treatment for cases of arthritis that don’t respond to more conservative treatments, such as rest and pain medication. Arthritis surgical options range from minimally invasive procedures to total joint replacements.
Read on to learn about the use of surgery to treat arthritis, including types, pros and cons, and recovery time.
Generally, doctors recommend trying conservative treatments before considering surgery.
Common nonsurgical treatments for arthritis include:
- rest
- changing exercise routine or activity level
- steroid injections
- medications
- physical therapy
- applying heat or ice
If none of these treatments offer relief, you and your doctor can suggest best next steps. Surgery may help improve your joint function, reduce pain, and prevent further joint damage. The decision to pursue surgery for arthritis varies on your individual case, and other personal health factors.
Many different types of surgeries are available to treat arthritis.
The best option for you depends on multiple factors, including:
- which joint or joints are affected
- how severe your arthritis impairment is on your life
- your overall health
- your age
- other personal risk factors
Let’s explore what different procedures look like, and what research says surrounding their effectiveness.
An arthroscopic procedure is performed with a tool called an arthroscope — a thin, flexible tube with a light at the end. Surgeons guide this tool through a small incision to do 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 anaesthesia, and have a quicker recovery.
However, arthroscopy is not considered the go-to arthritis treatment, and many doctors caution against it. For example, the Arthritis Foundation actively discourages arthroscopy to treat osteoarthritis. Research shows that arthroscopy usually doesn't provide
A total joint replacement (TJR) replaces a damaged joint with an artificial implant made out of metal, plastics, or ceramics.
A TJR is most often performed on the knee or hip, but can be done elsewhere.
A 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 the original surgery.
The best candidates for a total joint replacement are people with severe pain who haven’t found relief with less invasive treatments. Your doctor may recommend this procedure if you have constant pain
Recovery from a total joint replacement can be a long 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 pain and swelling to go down, and up to a year for swelling to disappear completely.
A partial joint replacement only replaces part of your knee or hip instead of your entire joint. For the knee, the most common way it’s performed is by removing the inner or outer compartment. For the hip, the joint socket is replaced with a metal cup, and the ball of the joint is capped 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 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 replacements are less active people with arthritis in one of the three compartments of their knee. The best candidates for a partial hip replacement are men under 50 with a large build, in particular athletes and people with physically demanding jobs.
Partial joint replacement may not be appropriate for people with smaller bone structures.
Returning to daily activities after your procedure tends to take about 3 to 6 weeks. Many people can return to sports like golf in 6 to 10 weeks. Hip resurfacing typically causes pain and discomfort for several weeks after surgery, and you’ll most likely resume regular activity after about 6 weeks.
An osteotomy involves cutting one or more of your bones, or adding a wedge near your damaged joint, to prevent further damage. For example, a knee osteotomy involves cutting and reshaping either your shin bone or upper leg bone to relieve pressure on the joint.
According to the Arthritis Foundation, the best candidate is in their 30s and younger than what’s usually recommended for a total joint replacement.
Osteotomy can delay the need for a joint replacement by more than a decade. However, they’re complicated and highly specialized.
A knee osteotomy may be performed in people with early-stage osteoarthritis on one side of the knee. A hip osteotomy may be recommended for young adults with arthritis isolated to a small part of the hip. The procedure involves cutting the femur or pelvic bone to prevent further cartilage deterioration.
After a knee osteotomy, you may be able to resume normal activities after 3 to 6 months. After a hip osteotomy, it may 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 joint cavity filled with fluid and are lined with a thin membrane called the synovium.
Synovial joints include:
- knees
- elbows
- shoulders
- fingers
- hips
- wrists
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 the entire damaged synovium to relieve pain and improve joint function.
Candidates for a synovectomy include people with inflammatory arthritis with only minor cartilage damage in a joint and who didn’t respond to anti-inflammatory medications. A potential complication of the procedure is a limitation in your range of motion.
The surgery has fewer complications when performed with an arthroscope than with traditional incisions.
The recovery time depends on the joint you have treated but generally takes a minimum of 3 weeks.
Joint fusion may be required if you have severe damage from osteoarthritis or inflammatory arthritis. During the procedure, your 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 will grow between the two bones.
This surgery may be performed on your:
- ankle
- wrist
- finger bones
- spine
Fusion of the knee or hip is rarely performed.
Joint fusion offers permanent results. The downside of this procedure is it can alter your range of motion and flexibility and lead to problems in other joints due to altered biomechanics. Fusion of a joint like your spine is a major operation. It’s common to need to wait 6 months to a year before being able to return to some activities.
Joint fusion is usually only performed to treat severe arthritis pain. It was a more standard treatment to treat arthritis before the development of joint replacement surgery.
A joint revision surgery replaces a malfunctioning or damaged implant. Joint replacement usually lasts more than a decade before needing replacement.
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Factors that may lead to the need for early revision surgery include:
- loosening of the joint implant
- dislocation
- infection
- worsening joint problems
Revision surgery is highly variable based on your individual situation. Often, the procedure is more complicated than the original procedure.
It may take up to 12 months to recover from knee revision. Recovery from hip revision surgery may take 12 to 18 months.
Every surgery comes with potential complications. It’s important to talk to your doctor about potential risks before choosing a surgery so you can weigh the pros and cons.
In some cases, the original surgery isn’t successful at treating your arthritis, and you’ll need a second procedure. If your surgery or revision isn’t successful, you may have more pain or a more limited range of motion than before.
If you receive a joint replacement, there’s a small chance that there will be problems with the implant itself. This can include mechanical malfunctions, or an inflammatory allergic reaction from your immune system.
Other potential complications of arthritis surgeries include:
- adverse reaction to anaesthesia
- infection
- blood clots
- nerve injury
- bruising
- ligament or blood vessel injury
- loss of range of movement
- persistent pain
For knee replacement surgery, complications occur in about 1 in 20 people.
Arthritis can cause significant pain and discomfort. Depending on the joints affected, 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 medication, 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 case and individual health factors. Talk to your doctor about the pros and cons of arthritis surgery, what options are available to you, and any concerns you have about complications.
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