Rheumatoid arthritis (RA) is a form of inflammatory arthritis that affects synovial joints. Although there is no cure, there are surgical options available to help reduce the impact on specific joints or reduce pain and increase function.

Synovectomy

There are several medications used for the management of RA. However, finding the right combination of medications can take a significant amount of time. Without an adequate treatment response, you will continue to experience joint destruction and the damage is irreversible. You may want to consider the option of a synovectomy if you have one or two joints with significant inflammation that is preventing you from doing your job or caring for yourself.

A synovectomy is used to help minimize or eliminate the destruction of a specific joint. During a synovectomy the synovial membrane is removed, which is the target of the autoimmune response. If the operation is successful, it can minimize or reduce the need for joint fusions or replacements in the future and quickly reduce pain in the joint.

Joint Fusion

Although any joint can be affected by RA, the small joints of the hands and feet are especially vulnerable to the effects of RA. These areas are more prone to deformities and destruction of cartilage, and the joint changes often appear earlier in the disease process. This can limit your activities of daily living or make it difficult to walk.

In some cases, joint fusion surgery may be an option to help correct deformities and reduce pain. However, the surgery is not always an easy decision. With joint fusion comes the loss of motion. This can be especially problematic with the joints of the fingers, since the dexterity required to do ordinary tasks can be limited. Significant post-operative physical therapy is needed after a joint fusion to help you adapt to new ways of doing common tasks.

Joint Replacements

When you have a long history of moderate to severe RA that has affected your knees or hips, you may need to consider a joint replacement. If your knees or hips have been severely affected, it is often better to make the decision for surgery sooner rather than later. Since RA commonly affects your joints in a symmetrical pattern, you want to have surgery while you still have decent function in your other knee or hip.

Choosing surgical options for severe RA can be a difficult decision, especially since the underlying disease process is ongoing. There are multiple options available to help reduce pain and improve quality of life. If you have questions, consider contacting a local orthopedic surgeon to discuss your concerns.

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