• Posted April 20, 2023

What Arthritis Surgeries Help With Pain and Other Symptoms?

Surgery may help you manage pain and other symptoms if you have certain types of arthritis or your arthritis is severe.

To help you decide if surgery is right for you, here's a breakdown of five of the most common arthritis surgeries, including what they involve, how they're performed, who the best candidates are and what recovery may look like.

Arthroscopy surgery

With arthroscopy, a few small cuts are made by a surgeon and a tube with a camera on the end is inserted, along with specialized surgical instruments used to repair the joint. The camera projects your joint's image onto a screen so doctors can see it better.

According to University of Washington Medicine, the surgery is used to take a tissue biopsy sample, repair torn cartilage, smooth a rough joint, remove torn tissue around a joint, reconstruct ligaments and even perform joint fluid repair. Since it's a less invasive type of surgery, arthroscopy recovery times are typically faster than other surgeries.

The Mayo Clinic mentions that arthroscopy may be performed on those with infectious arthritis, while New York-Presbyterian notes that it can be somewhat beneficial for relieving rheumatoid arthritis symptoms.

The best candidates for arthroscopy are active individuals aged 40 and under, according to the Arthritis Foundation. However, the foundation does not recommend arthroscopy surgery for people with osteoarthritis (OA), since there's a lack of evidence it relieves that condition's pain symptoms.

Total joint replacement (TJR) surgery

During total joint replacement (TJR), the entire joint and surrounding damaged tissues are removed and replaced with an implant, according to Southcoast Health.

People with more severe forms of rheumatoid arthritis and osteoarthritis who aren't responding to other treatments are the best candidates for this surgery. It's mainly performed on the hips, knees and shoulders, although it's sometimes done on fingers, elbows, ankles and other joints.

Accordington to Arthritis Australia, this surgery is also an option for people living with advanced psoriatic arthritis.

Although it is usually only performed on older adults, the Arthritis Foundation says that TJR is an option for children with juvenile arthritis as a way to help restore mobility in extremely damaged joints.

Joint resurfacing surgery

Joint resurfacing surgery is also called partial joint replacement. It's similar to TJR, except that only part of the joint is removed and replaced with an implant.

The Arthritis Foundation notes that hip resurfacing is a good option for those under age 50, especially men with larger builds. It allows you to continue high-impact activities and maintain more flexibility than TJR. For the knee, resurfacing is recommended if your arthritis is only in one compartment.

Unlike TJR, however, knee and hip resurfacing is not recommended for slimmer people or anyone with osteoporosis. The surgery also tends to have higher complication rates than TJR.

Dr. Paul DeMarco, Rheumatology Fellowship Training Program Director at U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases, said that having a recovery plan for both partial and total joint replacement surgery is crucial because it's one of the more challenging joint surgeries to recover from.

"It is important to think about available support systems in the postoperative period, so having family or friends available to assist is important,"he said. "Transport to postoperative physical therapy is equally important."

Joint revision surgery

Revision surgery for joints involves replacing a previously implanted artificial device that was inserted during a TJR or joint resurfacing surgery. It's recommended when your implant fails, becomes infected or is damaged.

Typically, the younger you are when you have your implant, the higher the chances that you'll need revision surgery. This is because these artificial implants usually only last 15-20 years, according to the Arthritis Foundation.

In fact, an analysis published recently in The Lancet Rheumatology revealed that up to 35% of knee joint replacement surgeries are revised in younger males.

Hip revision surgeries have also increased significantly in the United States, according to a study published in The Journal of Joint and Bone Surgery, particularly among people ages to 45-64.

Osteotomy

The Arthritis Foundation states that osteotomy surgery involves cutting, removing and reshaping bone, typically in the knee or hip. It's a procedure that is usually recommended for those under age 40 and may help delay a TJR by 10 to 15 years.

According to Brigham and Women's Hospital, this surgery is often performed on people with the most common type of arthritis, osteoarthritis, to help shift weight off damaged joint cartilage and reduce pain.

If you choose any of these surgeries to treat your arthritis, DeMarco suggested putting together a post-surgery plan of action to "include an understanding of what type of medications the doctor will provide, and what type of alternative therapies will be useful for management and return to activity."

SOURCE: Paul DeMarco, MD, Rheumatology Fellowship Training Program Director, U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases