Surgical Procedures for Rheumatoid Arthritis
Surgical procedures are generally used only on patients who haven’t had improvement with medications.
Arthroscopy
During an
arthroscopy
, tiny incisions are made on the sides of your knee. A small, lighted camera is inserted through one incision. The view inside your knee can be broadcasted onto a large monitor in the operating room. Operating instruments are passed through the other incision. These instruments are used to clean out shards of bone and cartilage that might be causing pain and interfering with movement.
Arthroscopy has recently been shown to have no benefit over conventional non-surgical treatment of joint conditions.
Osteotomy
In this procedure, a deformed joint (usually the knee) is realigned surgically to put more weight on the least affected side of the joint.
Synovectomy
In this operation, the inflamed synovium, the tissue that lines the joint, is removed.
Arthroplasty
This is joint replacement surgery. The joint is usually replaced with a synthetic joint, such as one made of a chromium alloy and plastic.
Knee replacements
and
hip replacements
are particularly common.
Arthrodesis
Arthrodesis is a last resort for patients who have not had good pain relief from other efforts. In this procedure, the two bones making up a joint are permanently fused together. While this can greatly improve pain, it also means that the joint is permanently nonfunctional.
References
Arthritis Foundation
website. Available at:
http://www.arthritis.org/
.
Ferri F, ed.
Ferri’s Clinical Advisor 2010
. 1st ed. Philadelphia, PA: Mosby Elsevier; 2009.
Firestein ED, et al.
Kelley’s Textbook of Rheumatology
. 8th ed. Philadelphia, PA: Saunders; 2008.
Goldman L, Ausiello D, eds.
Cecil Textbook of Internal Medicine
. 23rd ed. Philadelphia, PA: Saunders; 2008.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
website. Available at:
http://www.niams.nih.gov/
.