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When Is Surgery Right for Rheumatoid Arthritis

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When Is Hip Replacement Surgery Needed?

Hip replacement surgery is a procedure in which a doctor surgically removes a painful arthritic hip joint and replaces it with an artificial joint. It usually is done when all other treatment options have failed to provide adequate relief. The procedure should relieve a painful hip joint, making walking easier.

Hip replacement surgery can be performed traditionally or by using what is considered a minimally-invasive technique. The main difference between the two procedures is the size of the incision.

The small cuts are thought to lessen blood loss, ease pain following surgery, shorten hospital stays, reduce scar appearance, and speed healing.

What Other Surgeries Are Used for Rheumatoid Arthritis?

Other procedures for rheumatoid arthritis may include the following:

  • Carpal tunnel release. This can relieve the pain of carpal tunnel syndrome (compression of a nerve in the hand).
  • Synovectomy. This is the removal of the abnormal joint lining to prevent it from eroding cartilage and bone. While effective, eventually the joint lining (synovium) may grow back and the surgery may need to be repeated.
  • Bone or joint fusion surgery. Called arthrodesis, bone or joint fusion surgery is performed to relieve pain in the ankles, wrists, fingers, thumbs, or spine. In arthrodesis, two bones on each end of a joint are fused, eliminating the joint itself.

What Should I Expect From RA Surgery?

If your doctor recommends surgery for joint damage due to RA, what can you expect? There are some things to think about and steps you can take to make the surgery and your recovery more successful.

  • Your doctor may temporarily stop some of your medications, because they may lead to immune system suppression that would make infection more likely.
  • You may need to stop aspirin or other blood-thinning drugs a week or so before the operation.
  • Before knee or hip surgery, your doctor may have you practice walking on crutches to strengthen your arm muscles.
  • You may need to give blood in advance in case you need it during the surgery.

There are several things you can do to lower your risk of complications during surgery and improve your recovery.

  • If you have any tooth or gum disease, have it treated before the surgery. This helps prevent infection from bacteria in your mouth.
  • Report any discomfort with urination to your doctor. If you have a urinary infection, it should be treated before the surgery.
  • Eat a healthy, balanced diet. This will give you the energy and nutrition you need to heal faster.
  • Exercise. People with a higher fitness level do better after surgery.
  • If you smoke, quit! Stopping smoking reduces the risk of complications from surgery.
  • Lose weight. Less weight means less stress on the artificial hip or knee, making it last longer. Some surgeons will not perform joint replacement surgery on a hip or knee unless a person is less than 300 pounds.
  • Prepare your home. You will need someone to help you with cooking, cleaning, and shopping while you are recovering. Make your home fall-proof by taping down loose carpets or electrical cords.

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