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When Is Surgery Right for Rheumatoid Arthritis

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Drugs for rheumatoid arthritis (RA) can slow down the disease. However, after joint damage has occurred, surgery may be a reasonable option. Advancements in surgical treatment are giving people with rheumatoid arthritis more chances to maintain function and keep moving.

Having surgery is never something to enter into lightly, but sometimes it can really help. When is the right time for surgery for rheumatoid arthritis, and what can you expect?

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There are a couple of reasons to choose surgery for rheumatoid arthritis:

  • Relieving pain. Pain relief is the most consistent benefit of orthopedic surgery.
  • Improving function. Repair or replacement of a weakened joint may help you regain some of your previous activity level.

When Can Surgery Help Rheumatoid Arthritis?

The first question to ask your doctor is, can surgery help your rheumatoid arthritis? When there is structural damage to a joint or the tissues around it, medicines can't fix it, and surgery may help. Determining whether surgery will fix a joint problem is complicated and requires consulting with your rheumatologist and an orthopedic surgeon.

The timing of surgery is also critical. Because any surgery is serious and can have complications, in general it's best to reserve surgery for when other treatments haven't helped. If surgery is delayed too long, though, it can be less successful. Figuring the optimal time to perform surgery requires close attention and consideration -- by both your rheumatologist and orthopedic surgeon.

What Is Total Joint Replacement?

The hip and the knee are the joints most often replaced in people with rheumatoid arthritis. The damaged structures are taken out, and an artificial joint -- or prosthesis -- put in. With proper care and depending on factors such as the person's physical condition, activity level, and body weight, the life of a replaced joint can be over 20 years. After that point, a second surgery is needed (revision surgery), which is more difficult and the outcome is not generally as good. Therefore, the timing of joint replacement surgery is critical.

When Is Knee Replacement Surgery Recommended?

If you have a stiff, painful knee that prevents you from performing even the simplest of activities and other treatments are no longer working, you may want to ask your doctor about knee replacement surgery.  

Minimally invasive surgery for the knee joint requires a much smaller incision, three to five inches long, versus the standard approach, which typically requires an incision eight to twelve inches long. The smaller, less invasive approaches result in less tissue damage by allowing the surgeon to work between the fibers of the quadriceps muscles instead of requiring an incision through the tendon. It may lead to less pain, improved recovery time, and better motion due to less scar tissue formation.

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