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Some patient with arthritis have too undergo surgeries in order to help relieve pain and restore joint motion. This article outlines the 8 different surgeries that serve as a treatment for arthritis.

Arthritis, a disease that is characterized by joint inflammation, is composed of more than a 100 individual subtypes including the two most common types, rheumatoid arthritis and osteoarthritis. Currently, there is no cure for arthritis. However, several different types of treatments can help improve symptoms, slow down disease, progression and maintain range of movement in your joints.

In extreme cases of arthritis where the pain is debilitating and non-responsive to medication, doctors may recommend that you undergo surgery. There are eight different types of surgeries that can be used to treat arthritis.

1. Arthroscopy

This is a type of surgery that involves the use of small incisions, specialized instruments, and a small camera that helps fix tears in the soft tissue that surrounds the knee, hip, shoulder and other types of joints. This type of surgery is able to remove broken, free-floating pieces of cartilage (soft cushioning in between bones) and repair damaged cartilage.

The ideal candidate for arthroscopy is one who is active and younger 40 years of age. The benefits of undergoing arthroscopy are that it helps immediately to reduce pain, increase the range of motion of joints, and helps improve other symptoms. Furthermore, arthroscopies can also either delay or completely eliminate the need for an artificial joint. The disadvantage of arthroscopy is that, as of now, there are no long-term studies that support the idea that arthroscopy can stop degeneration of the joint.

2. Joint resurfacing

When conducted in the knee, this type of surgery is called either a unicompartmental or partial knee replacement. During this procedure, surgeons replace only one of the three compartments of the knee with an implant. The best candidates for joint resurfacing are older, less active patients who have involvement of only one compartment of the knee.

When joint resurfacing is conducted in the hip, surgeons put a metal cup as a replacement for the hip socket and the damaged hip ball is reshaped and capped with a metal prosthesis. This type of surgery is advised for men younger than 60.

Joint resurfacing can help relieve pain and improve the ability to carry out daily activities. However, there is a high complication rate associated with conventional implants. Thus, it is not recommended for patients with osteoporosis, kidney disease or diabetes.

3. Osteotomy

Osteotomy is a type of surgery that involves cutting and removing bone or adding a piece of bone near a damaged joint. An osteotomy can be helpful as it shifts the weight from a region of your bones that is damaged by arthritis to an undamaged region. Often, an osteotomy is used to correct a misalignment which has taken place earlier in life. The prime candidates for this type of surgery are patients in their thirtiess and younger, as these patients are often too young to undergo a total joint replacement. The benefits of osteotomy include the fact that it can stop damage and cause a delay in the need for joint replacement. However, it’s a highly complex procedure and only a few surgeons are ideally suited to performing it.

4. Synovectomy

Synovectomy is a type of surgery that is conducted in patients that have inflammatory arthritis, a disease in which the synovium (which lines the joints) becomes inflamed or grows too much, thus causing damage to the joints. In this surgery, surgeons remove most or all of the synovium of the joint affected.

The best candidates for a synovectomy are patients that have limited cartilage damage in the affected region and those that have tried anti-inflammatory medications but their disease remains unresponsive. The benefits of this surgery are that is helps relieve pain and improves functioning of joints. However, this surgery can also limit the range of motion and provide only a temporary relief of symptoms.

5. Arthrodesis or Fusion

This is a procedure in which surgeons use pins, plates, rods or other tools to join two bones together to causes the two bones to make one continuous joint. The best candidates for this type of surgery are patients with severe joint damage due to osteoarthritis or inflammatory arthritis. While this surgery is very durable and the results should last a lifetime, fusing joints can often reduce their motion and flexibility.

6. Total Joint Replacement (TJR) or Total Joint Arthroplasty 

TJR involves replacing a damaged joint with an implant that imitates the motion of the original joint. This type of implant is made from metal, plastic and/or ceramic compounds. This is best suited for people that have severe joint pain which is non-responsive to other treatments. It is more commonly conducted in young patients compared to older patients. TJR is beneficial in that it reduces pain and improves mobility. However, artificial joints can eventually wear out and may require joint revision surgery. Implants can also cause some health issues.

7. Minimally-invasive TJR

This is a type of surgery that involves replacing a damaged joint with an implant using shorter incisions compared to the traditional TJR. This is beneficial in that it cuts and reattaches less muscle. Patients best suited for this type of surgery are younger people who are active and of normal weight. The benefits for this type of surgery include less pain and less time in the hospital than a traditional joint replacement. However, minimally invasive TJR is associated with high complication rates.  

8. Joint revision

This a type of surgery that is conducted to remove a failed, infected or worn-out implant and to replace with a newer one. This is conducted in patients who have a damaged artificial joint. While implants nowadays are good and can last 20 years or longer, many people that got them as young adults will eventually need a revision. The benefits include improved pain relief and mobility. However, revisions surgeries are generally more complex and less successful than original replacement surgery.

  • Bachmeier, Clarissa JM, et al. "A comparison of outcomes in osteoarthritis patients undergoing total hip and knee replacement surgery." Osteoarthritis and cartilage 9.2 (2001): 137-146.
  • Moseley, J. Bruce, et al. "A controlled trial of arthroscopic surgery for osteoarthritis of the knee." New England Journal of Medicine 347.2 (2002): 81-88.
  • Kirwan, J. R., et al. "Overall long-term impact of total hip and knee joint replacement surgery on patients with osteoarthritis and rheumatoid arthritis." Rheumatology 33.4 (1994): 357-360.
  • Scott, D. L., et al. "The clinical management of rheumatoid arthritis and osteoarthritis: strategies for improving clinical effectiveness." British journal of rheumatology 37.5 (1998): 546-554.
  • Photo courtesy of SteadyHealth

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