Gout is a painful form of arthritis caused by too much uric acid in the body (hyperuricemia) leading to uric acid crystals building up in the joints. It commonly affects one joint at a time, often the big toe joint.
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If gout is treated with medication and lifestyle changes, most people can keep gout from advancing. Medication and lifestyle changes can also reduce pain and prevent attacks.
If you have had poorly controlled or untreated gout for more than 10 years, there is a chance that your gout has advanced to the disabling stage known as chronic tophaceous gout.
With tophaceous gout, hard deposits of uric acid form lumps deposited in and around the joints and certain other locations, such as the ear. These aggregates of sodium urate monohydrate crystals below the skin are called tophi.
Because tophaceous gout can cause irreparable damage to your joints, one of three surgical treatments is often recommended: tophi removal, joint fusion, or joint replacement.
Tophi can become painful and inflamed. They can even break open and drain or become infected. Your doctor might recommend that they be surgically removed.
If advanced gout has permanently damaged a joint, your doctor might recommend that smaller joints be fused together. This surgery can help increase joint stability and relieve pain.
To relieve pain and maintain movement, your doctor might recommend replacing a joint damaged by tophaceous gout with an artificial joint. The most common joint that is replaced due to damage from gout is the knee.
If you are diagnosed with gout, take your medications as prescribed by your doctor and make the lifestyle changes they recommend. These steps can help prevent your gout from advancing and requiring surgery.