If you get little or no joint pain relief from osteoarthritis medications, it may be time to consider joint surgery.
How do you decide? First, ask yourself and your health care provider the most important question: Is there any other treatment for osteoarthritis you could try? Second, is joint surgery necessary? Third, ask an orthopedic surgeon about the best surgery for joint pain relief in your particular situation. The surgeon will recommend a type of joint surgery based on the severity of your osteoarthritis and the specific joints that hurt.
After a skiing injury 30 years ago, Bert Pepper, MD, got osteoarthritis in his left knee. "I stopped skiing and gave up tennis, running, and other sports that are tough on the knee," he says. "I turned to speed-walking to stay fit, but the knee kept me from walking at a good pace."
As his pain got worse and walking became harder, he looked into having a knee replacement. It's not a decision to make lightly, says Pepper, who is a psychiatrist. "It's a major life event. You have to be prepared to...
Here are brief summaries of the five types of joint surgery for osteoarthritis pain. Immediately after these summaries, you'll find in-depth descriptions of each surgery commonly used for joint pain relief.
Arthroscopy: A procedure that involves making a small incision near the damaged joint and inserting an arthroscope to see inside the joint.
Total joint arthroplasty (also called total joint replacement): Removal of a damaged joint and replacement with a new one; parts of joints may also be replaced (partial joint arthroplasty).
Osteotomy: Cutting the bones near the joint and repositioning them to realign osteoarthritis-related deformities and move them away from joint bearing areas.
Arthrodesis (joint fusion): Surgical joining together of osteoarthritis-affected joint bones to make them nonmovable.
Resection arthroplasty: Removal of all or part of a joint to eliminate damaged surfaces from moving against each other.
Arthroscopy for Joint Pain
The arthroscope is a telescope with a tiny light and video camera, inserted through a small incision and connected to a video monitor. The surgeon views the monitor to identify and treat areas needing repair.
Today arthroscopy is typically used to remove painful free-floating pieces of bone and other tissue in the knee. These loose bodies float between the joint surfaces and are like gravel in a ball bearing, wearing down the surface of the joint as it moves. Damaged cartilage can also be trimmed or removed.
Arthroscopic joint surgery may be done in a surgical clinic or a hospital, but usually does not require an overnight hospital stay.
Benefits and Risks of Arthroscopy
Compared with more invasive forms of joint surgery, arthroscopy offers important benefits, including:
Reduced surgery time
Less tissue damage and blood loss
Less pain after surgery
Lower risk of complications
Arthroscopic joint surgery carries few risks, mainly those associated with any type of surgery. The risks you should discuss with your surgeon include:
A reaction to anesthesia
Bleeding inside the joint, or a blood clot
Blood vessel or nerve damage
Damage to cartilage, muscles, ligaments, or tendons
What Happens During Arthroscopic Joint Surgery
Arthroscopic joint surgery may take as little as an hour to complete. The surgeon starts by making a small incision in the joint area, inserting the arthroscope, and filling the joint with saline solution to enlarge the joint and to get a better view. Moving the scope and watching a magnified view of the joint on the monitor, the surgeon may make additional repairs through additional small incisions.