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Surgery

Surgery is always the final option to treat any condition, however, if your rheumatoid arthritis is severe enough to need it, you may require joint  surgery, such as arthroscopy, synovectomy or joint replacement.

Modern technology today allows us to successfully replace part or the whole joint so that it can work effectively again. Joint replacement uses an artificial joint to replace severely damaged joints in the body, and as these are artificial joints, they are also subject to wear and tear, and may need to be replaced later, hence this form of surgery us usually reserved for older patients.

It is also very important to keep in mind, that joint replacement surgery will not allow you to do more than you could before had arthritis, you will experience a great reduction in pain, and improvement in your mobility, but it takes time, about 6 weeks to recover and several months to get your strength back with regular exercise advised by your doctor.

Other forms of surgery are; synovectomy – which involves removing the lining of the joint, which is particularly effective to treat rheumatoid arthritis, however the ‘synovium’ can eventually grow back, and your symptoms may return.

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Arthroscopy is a form of keyhole surgery, where there is a small tube with a fiber optic camera which is inserted into the joint. This form of surgery is usually used to clean up a joint, and remove torn or damaged cartilage.

There are other types of surgical procedures that may help to treat your rheumatoid arthritis, your doctor and/or specialist will be able to identify what type of surgery (if you need it at all) is best for your condition.

Preparing for surgery:

• Discuss all options with your doctor, and ask about risks, outcomes, recovery time and rehabilitation.
• If you are a smoker, cut down or quit before surgery, to improve recovery and reduce chances of complications during surgery.
• If you are overweight, reducing your weight before surgery will lessen the load on the joints and improve recovery time. However, do not try to loose weight one month before surgery, as this can cause the body additional stress.
• Anti-inflammatory medications can cause complications during surgery, they should not be taken one week prior to your operation.
• Other medications can also cause complications during surgery, discuss all medications and supplements with your doctor as you are planning for your surgery.
• Any other conditions, infections or problems should also be reported to your surgeon.
• Check your health cover insurance, to understand what you are covered for, not just your surgery and hospital stay, but also physiotherapy and other assistive and therapeutic measures you may need post operation. Plus home modifications, follow up visits to your surgeon, etc.

Preparing to come back home:

• Before you have your surgery, you should think about making things easier for yourself around the home.
• Organise to have someone help you when you return home, to assist with cooking, cleaning and shopping etc.
• Install handles and rails where you need them. Near stairs and in the bathroom etc.
• Have a plastic non-slip seat in the shower, so you can sit down and possibly an elevated toilet seat to assist you in the bathroom.
• A comfortable chair with armrests and area set up for you, with items you use often within easy reach, such as phone and other necessities.

Rehabilitation

Your rehabilitation after surgery will depend on the type of surgery you had, and your physical condition. It generally takes 6 weeks to recover and gain back your strength from joint replacement surgery before you can begin to drive and do other every day tasks. Your doctor and/or your physiotherapist will be able to tell you when you are ready. ?A rehabilitation program will be designed for you and you will most likely be advised to continue with an exercise program after this program has finished. It is important to continue to exercise to keep your joints strong and stable. Activities such as swimming, aqua aerobics, walking, and tai chi will keep the joints mobile and strong, and can prevent further injuries. Your physician will advise you to avoid ‘high-impact’ activities, such as running, jogging, tennis, skiing and jumping, as this can cause stress to the new joint.