Surgical Procedures for Arthritis Pain
If and when you can no longer manage the pain or deal with the loss of mobility caused by your severe arthritis through non-surgical treatments, surgery may offer some relief. Your physician or surgeon can discuss with you in-depth your surgical options. Below we've listed the most common surgical interventions recommended to arthritis sufferers.
- Total joint replacement.
People with advanced symptoms of arthritis that cannot be managed with medications or physical therapy are often candidates for total joint replacement surgery. With total joint replacement, the old, worn out surface of the joint is surgically removed and a new synthetic surface is put in place.
When osteoarthritis occurs, small pieces of cartilage tend to wear away from the joint surface and float around inside the joint. This debris is thought to cause inflammation and pain. In certain cases of arthritis, your doctor may suggest arthroscopy to try to remove some of the debris and provide temporary pain relief. Arthroscopy is a minimally-invasive surgical procedure in which degenerated and worn cartilage is trimmed and smoothed, reducing the source of inflammation.
- Cartilage transplant.
It is now possible to transplant cartilage from one location to another. Healthy cartilage from an area of the joint that does not bear weight, can be transplanted to another area where weight-bearing cartilage has been damaged. Unfortunately, in most cases of advanced arthritis, the degeneration and wear of cartilage involves the majority of the joint surface, and cartilage transplant is not always a viable treatment option.
- Fascial reconstruction.
Before artificial joints, surgeons tried many things to keep the worn-out bone surfaces of arthritic joints from rubbing against each other. Surgeons found that fascia - the connective tissue that makes up the covering of muscles - could be placed between the rubbing bone surfaces to create a tough connection of scar tissue that cushioned the ends of the bones. This approach is still used in some cases.
Before the advent of artificial implants, fusion was much more common than today. In fusion, the joint is removed and the bone ends are allowed to grow together, or fuse, into one bone. Patients who undergo fusion regain strength in the fused joint, but they lose mobility - the joint doesn't move. Fusion is an option for patients with compromised immune systems or other systemic diseases that would significantly impact the potential success of joint replacement.
Osteotomy is an operation that cuts the bone, either above or below the joint, and re-aligns the joint to a better position. An osteotomy is often used for younger people where the limb is clearly not straight and the cartilage wear is confined to one part of the joint. Unfortunately, the success of this operation decreases as the degree of arthritis increases.