Surgery Sometimes, if damage to a joint is severe enough to make life very difficult and other treatment isn't helping, your doctors may recommend surgery.

Here are some of the different types of surgery options for severe arthritis:

• removal of the inflamed lining of the joint
• removal of the painful covering of tendons
• release or repair of tendons
• removal of bone to relieve pain
• release of trapped nerves
• fusing joints to make them more stable and pain free
• replacement of a damaged joint with an artificial joint

Joint replacement is the most common form of surgery for arthritis, with around 60,000 people in the UK having a hip replaced every year, and around 56,000 people having a knee replaced. Ankles, shoulders, elbows, wrists and fingers can all be replaced too. Artificial joints don't work as well as natural joints, but they do enable about 95 per cent of people who have the operation to be free of pain for the lifetime of the joint - around 15 years, sometimes longer. Joint replacement also helps to regain a significant amount of joint movement, around 75% of the range of movement of a normal joint.

One in 20 joint operations fails and complications can set in. The operation is major, so the decision to have a joint replacement shouldn't be taken lightly. If your doctor suggests it, discuss what's being offered and why. The decision will ultimately be yours.

If you want to go ahead, you'll be referred to an orthopaedic surgeon. You can ask your rheumatologist about the performance and experience of the person to whom you are being referred. If they can't help, all NHS trusts should have a Patient Advice and Liaison Service (PALS); see the Department of Health website for further details. For patients in England, the Royal College of Surgeons of England website also has lots of useful advice for patients and their families.

This article was last medically reviewed by Dr Rob Hicks in July 2008.
First published in October 1999.