Do I Need Surgery for Osteoarthritis?

Osteoarthritis (OA) is a disease of the joints. It can be painful and may cause your joints (fingers, knees, hips, and others) to become inflamed or swollen. OA happens when the soft and rubbery articular cartilage that covers the ends of your bones wears away. That causes them to rub against each other when the joint is moved.

The condition occurs mostly in older people because it's one that develops with wear and tear over many years. You're also more likely to have OA if you're obese, have relatives who have it, or have had a previous joint injury.

Once you're diagnosed with OA, your doctor may tell you to try lifestyle changes like exercise, weight loss, physical therapy, pain medicine, or natural remedies. But, if these don't work, he may suggest surgery.

Types of Surgery

There are several different types of surgeries you could have depending on where your injury is and how much pain you are experiencing. Here are some of the procedures, along with the pros and cons of each:

Arthroscopy: The surgeon inserts a pen-sized flexible tube called an arthroscope inside your joint. The arthroscope has a fiber-optic video camera attached so she can see inside your joint. By making a few small incisions, the doctor can smooth rough spots. She can also remove cysts, damaged cartilage, or bone fragments from inside.

This is a quick surgery and has less recovery time than the others. However, studies show that arthroscopic knee surgery has limited uses. The procedure seems to be effective only for very specific injuries -- for instance, it is useful if you have a knee that locks up when you try to play a sport, but is less successful for treatment of OA.

Total joint replacement (arthroplasty): The surgeon takes out the diseased parts of your bones and replaces them with an artificial joint using metal or plastic parts. Total joint replacement usually reduces your pain dramatically and improves quality of life. However, artificial joints will wear out over time and you might have to have another replacement in about 20 years.

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Osteotomy : The surgeon cuts bone near a damaged joint or adds a wedge of bone to realign your leg or arm and remove pressure. It's a difficult surgery and it doesn't appear to be as effective in relieving pain as joint replacement surgery.

Joint fusion: The surgeon uses pins, plates, screws, or rods to join two or more bones together to make one continuous joint. Over time, the joints will fuse together. This surgery will normally last a lifetime and should reduce your pain. But, it eliminates mobility and flexibility and can put stress on other joints. That can cause OA to spread to other parts of your body.

No matter what surgery you may have, it’s not a substitute for a healthy diet and exercise. You'll still need to take care of yourself after surgery and commit yourself to rehab.

Questions to Ask Yourself

Before deciding whether to have surgery for OA, ask yourself the following questions:

  • Can you live with the pain you're experiencing?
  • Do your pain medications have side effects that are difficult for you to deal with?
  • Has your pain gotten worse over the past year?
  • Have you tried all other treatments?
  • Are you healthy enough for surgery?
  • Are you committed to the post-recovery process of physical therapy and exercise?
  • Will your insurance pay for it?
WebMD Medical Reference Reviewed by Minesh Khatri, MD on March 25, 2017

Sources

SOURCES:

Arthritis Foundation: "Is It Time for Joint Surgery?" "Osteoarthritis Treatment,"

"Surgery: Why Wait? Why Not?" "Understanding Your Joint Procedure Options."

OrthoInfo: "Osteoarthritis."

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