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Surgical Procedures for Rheumatoid Arthritis
Surgical procedures are generally used only on patients who haven’t had improvement with medications.
Rheumatiod arthritis can cause damage to nearby tendons. These injuries can make it difficult to move since tendons connect muscle to bone. Some tendons can also be damaged to the point of rupture. Surgery may be done if the tendon pain is not responding to conservative treatment or is interfering with daily activities.
A tendon reconstruction surgery will repair or replace damaged tendons with new tendon tissue. It is most often done on tendons of the hands.
Metatarsal Head Resection
Rheumatiod arthritis can cause a deformity of the joints. Deformity of joints in the feet can be painful and make it difficult to walk.
The metatarsal heads are the joints that make up the ball of the foot. The metatarsal head just below the big toe is most often affected by rheumatoid arthritis. A metatarsal head resection removes and remodels the bones involved in these joints. The surgery goal is to reduce the deformity, improve function, and reduce pain.
The synovium is a tissue capsule that surrounds the joint. Inflammation from rheumatoid arthritis develops in this tissue.
A synovectomy is the removal of the inflammed synovium. It is rarely done since the tissue will eventually grow back but it may be done with other surgical repairs. A synovectomy may provide temporary pain relief and slow the destruction of the joint.
This is a surgery to replace part or all of the damaged joint. A synthetic joint or devices, often made of a chromium alloy and plastic, will be used. The replacement is done to decrease pain and improve function.
Arthrodesis is a last resort for patients who have not had good pain relief from other efforts. In this procedure, the two bones making up a joint are permanently fused together. While this can greatly improve pain, it also means that the joint is permanently nonfunctional.
Rheumatoid arthritis. Arthritis Foundation website. Available at: http://www.arthrit... . Accessed July 24, 2013.
Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.n... . Updated April 2009. Accessed July 24, 2013.
Rheumatoid arthritis (RA). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what . Updated July 2, 2013. Accessed July 24, 2013.
Types of surgery. Arthritis Foundation website. Available at: http://www.arthrit... . Accessed July 24, 2013.
Last reviewed June 2013 by Michael Woods, MD
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