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Rheumatoid arthritis (RA) surgery

In some cases surgery may be recommended for joint damage caused by rheumatoid arthritis.

The goal of an operation or procedure for rheumatoid arthritis is to restore use of a joint, correct any deformities, and to reduce pain.

When can surgery help rheumatoid arthritis?

The first question to ask your doctor is, can surgery help? When there is structural damage to a joint or the tissues around it, surgery may be a better option than medication. Determining whether surgery will fix a joint problem is complicated - you need to consult with your rheumatologist and an orthopaedic surgeon.

The timing of surgery is also critical. Because any surgery is serious and can have complications, it tends to be delayed until it is really necessary. If surgery is delayed for too long, though, it can be less successful. Working out the best time to perform surgery requires close attention and consideration - again, by both your rheumatologist and an orthopaedic 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 (prosthesis) put in. The lifespan of a replaced joint is usually 10 to 15 years, depending on factors such as the patient's physical condition, activity level and body weight. After that, additional surgery is needed (revision surgery). This is more difficult to perform 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, or keyhole surgery, for the knee joint requires a much smaller incision - measuring three to five inches - than the standard approach, which typically involves an eight- to twelve-inch incision. The less invasive approaches cause less tissue damage, by allowing the surgeon to work between the fibres of the quadriceps muscles instead of making an incision through the tendon. This may result in less pain, an improved recovery time and better movement due to reduced formation of scar tissue.

When is hip replacement surgery needed?

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

Hip replacement surgery can be performed using traditional techniques or a minimally invasive or keyhole approach. The main difference between the two procedures is the size of the incision.

The smaller cuts are thought to reduce blood loss, lessen pain following surgery, shorten hospital stays, reduce scarring and speed healing.

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