Surgical treatment in rheumatoid arthritis is used to relieve severe pain and improve function of severely deformed joints that do not respond to medication and physical therapy.

Total joint replacement (arthroplasty) can be done for many different joints in the body. Its success varies depending on which joint is replaced.

Surgery Choices

Surgeries considered for people who have severe rheumatoid arthritis include:

• Finger and hand surgeries, to correct joint problems in the hand.
• Arthroscopy, which removes debris or inflamed tissue in a joint through a small lighted instrument.
• Synovectomy, to remove inflamed joint tissue.
• Arthroplasty, to replace part or all of a joint in the hip or knee.
• Cervical spinal fusion, to treat severe neck pain and nerve problems.
• Resection of metatarsal heads, to remove deformed bone in the feet.
• Total joint replacement of the hip, knee, or shoulder.

What to Think About

Joint surgery often restores near-normal movement in a person who has osteoarthritis in just one or two joints. However, this is not the case in people affected by rheumatoid arthritis.

• Rheumatoid arthritis usually affects multiple joints, particularly smaller joints, such as finger joints, which are needed for many daily activities. Surgical treatment may not be an option for all of the affected joints.
• Joint surgery or replacement can relieve disabling pain and restore enough motion to allow you to complete daily activities, but it will seldom restore the joint to normal.
• The most successful procedures for rheumatoid arthritis are carpal tunnel release (in the wrist), resection of the metatarsal heads (in the foot), and total hip and total knee joint replacements.

A consultation with an orthopedic surgeon who is experienced in joint surgery for rheumatoid arthritis is important before making a decision to have surgery. For more information on questions before surgery, see:

Questions to consider about joint surgery.