Osteoarthritis: Surgery for Joint Pain Relief
If you get little or no joint pain relief from osteoarthritis medications, it may be time to consider joint surgery.
How do you decide? First, ask yourself and your doctor the most important question: Is there any other conservative treatment? Second, is joint surgery indicated? Third, ask an orthopaedic surgeon about the best surgery for joint pain relief in your particular situation. Your doctor will recommend a type of joint surgery based on the severity of your osteoarthritis and the specific joints that hurt.
Types of Surgery for Joint Pain Relief
Here are brief summaries of the five types of joint surgery for osteoarthritis. Immediately after these summaries, you'll find in-depth descriptions of each surgery commonly used for joint pain relief.
- Arthroscopy: A small-incision procedure using an arthroscope to see inside the joint damaged by osteoarthritis.
- Total joint arthroplasty (also called total joint replacement): Removal of a damaged joint and replacement with a new one; parts of joints may also be replaced (partial joint arthroplasty).
- Osteotomy: Cutting and repositioning the joint to realign osteoarthritis-related joint deformities and move them away from joint bearing areas.
- Arthrodesis (joint fusion): Surgical joining together of osteoarthritis-affected joint bones to make them nonmovable.
- Resection arthroplasty: Removal of all or part of a joint to eliminate damaged surfaces from moving on each other.
Arthroscopy for Joint Pain Relief
The arthroscope is a telescope with a tiny light and video camera, inserted through a small incision and connected to a video monitor. The surgeon views the monitor to identify and treat areas needing repair.
Today arthroscopy is typically used to remove painful free-floating pieces of bone in the knee. Floating between the joint surfaces, these loose bodies are like gravel in a ball bearing, wearing down the surface of the joint.
Arthroscopic joint surgery may be done in a surgical clinic or a hospital, but usually does not require an overnight hospital stay.
Benefits and Risks of Arthroscopy
Compared with more invasive forms of joint surgery, arthroscopy offers important benefits, including:
- Reduced surgery time
- Less tissue damage and blood loss
- Less pain after surgery
- Lower risk of complications
Arthroscopic joint surgery carries few risks, mainly those associated with any type of surgery. Those you should discuss with your surgeon include:
- A reaction to Anesthesia
- Bleeding inside the joint, or a blood clot
- Blood vessel or nerve damage
- Damage to cartilage, muscles, ligaments, or tendons
- Infection
What Happens During Arthroscopic Joint Surgery
Arthroscopic joint surgery may take as little as an hour to complete. The surgeon starts by making a small incision in the joint area, inserting the arthroscope, and filling the joint with saline solution to enlarge the joint and to get a better view. Moving the scope and watching a magnified view of the joint on the monitor, the surgeon may work through additional small incisions.
At the end of surgery, the arthroscope and any other surgical tools are removed and the joint flushed with saline again. Local anesthetics may be injected into the joint to reduce pain.
When you're ready to return home, your surgeon may provide medication to ease pain and reduce inflammation.
Arthroscopy Surgery Recovery: What to Expect
For the next few days, follow your surgeon's instructions to care for the joint. These may include wrapping and icing it, resting it to help with healing, and elevating it to help reduce pain and swelling. You may need crutches, a sling, or splints to support it when you move about. Your surgeon may suggest physical therapy.
After arthroscopy, most people go back to their normal daily routine within days. It may take a few weeks before the joint recovers fully.
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