Surgery is not considered a first-line treatment for rheumatoid arthritis (RA). But a doctor may suggest a joint repair or replacement procedure if you have significant joint damage that interferes with your overall quality of life.

Rheumatoid arthritis (RA) is a chronic autoimmune condition that often requires long-term treatment to reduce symptoms and prevent further joint damage. This treatment typically involves a combination of medications and therapies.

Surgical joint repair or replacement procedures may possibly be a treatment option for RA in your hands and feet.

Learn more about surgery for RA in the hands and feet, including the types of procedures and how they might help treat this form of arthritis.

The goal of RA hand surgery is to help fix or totally replace affected joints throughout the hands, such as the ends of your fingers, or knuckles. This can help decrease pain, improve mobility, and possibly correct related structural changes.

Consider the following X-ray that shows differences before and after RA hand surgery:

before and after rheumatoid arthritis surgeryShare on Pinterest
Before and after rheumatoid arthritis surgery on hand. | © 2017 The Japanese Orthopaedic Association. Published by Elsevier B.V. CC-BY-NC-ND. Hajime Ishikawa; The latest treatment strategy for the rheumatoid hand deformity. Journal of Orthopaedic Science. Elsevier

RA foot surgery also aims to correct or replace small joints that may be interfering with your quality of life. It may also help treat structural changes in your feet, such as those affecting your toes and other areas of your forefoot.

Below is an X-ray image that details the differences before and after RA foot surgery:

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Before and after rheumatoid arthritis surgery on foot. | Copyright ©2012 Popelka et al.; licensee BioMed Central Ltd. CC BY 2.0 Popelka S, Hromádka R, Vavík P, Barták V, Popelka S Jr, Sosna A.

While surgery for RA is not common, it may still help in some cases of advanced joint damage. The overall success rate may depend on the type of surgery, the location of the affected joints, and your overall health.

How successful is hand surgery for arthritis?

The success rate for RA hand surgery is variable. For example, while an artificial hip or knee joint may last up to 20 years, about 30% of finger joint replacements fail within 10 years. This is due to the silicone material used for these joints and the way they move.

How successful is foot surgery for arthritis?

Foot surgeries for arthritis are also variable, with more success noted in joints in the front of the feet. However, as one 2020 review suggests, foot surgery may improve RA pain and mobility for 6 to 12 months.

Surgery for RA in the fingers and toes may correct structural changes that cause these joints to appear crooked. Prompt diagnosis and correction may also help prevent long-term mobility issues.

However, surgery for RA can also increase your risk of physical limitations due to damaged cartilage. It’s worth speaking with a doctor about the pros and risks of surgery and whether it might be right for your condition.

RA surgery may come in the form of arthrodesis or arthroplasty, as well as other possible procedures:

  • Arthrodesis: This type of joint fusion surgery involves repairing a joint by taking the bones on either side and joining (fusing) them together. It may be especially helpful for treating joint damage at the ends of your fingers, but it may be considered for other joints in the body, too.
  • Arthroplasty: Also known as joint replacement surgery, this procedure involves removing the damaged joint and replacing it with an artificial one. This may be considered for joints in the knuckles and base of your hands, as well as those around your toes and balls of your feet.
  • Subcutaneous nodule removal: While not generally recommended due to a risk of recurrence and infections, some skin nodules around the hands may be removed if they interfere with routine movements.
  • Synovectomy: This type of surgery involves the removal of inflamed synovial tissues surrounding an affected joint.
  • Tendon procedures: These include the possible realignment of transfer of tendons to improve pain and mobility, as well as to repair tendon rupture.
  • Tenosynovectomy: This procedure involves the removal of inflamed synovial tissues that may be affecting tendons.

While RA surgery may be considered in treating joints in the hands and feet, it may also help treat other joints throughout the body. These include joints commonly affected by RA, such as your:

  • wrists
  • elbows
  • shoulders
  • hips
  • knees
  • ankles

You may be a candidate for RA surgery if you have permanent damage to joints that impairs your day-to-day movements. A rheumatologist may refer you to an orthopedist, a type of doctor who specializes in treating bone and joint diseases, including surgeries.

Overall, RA surgery is considered rare. One review published in 2013 attributes a dramatic decrease in RA surgeries starting in the mid-1990s to the introduction of disease-modifying anti-rheumatic drugs (DMARDs).

While RA surgery isn’t common, it may still be considered when other treatments don’t work or if there are significant joint deformities present.

Still, joint repair and replacement procedures are not safe for everyone. An orthopedist will consider the risks versus benefits, including whether you’re healthy enough to undergo major surgery.

RA surgery, including for the hands and feet, isn’t as common as in previous decades due to advances in nonsurgical treatments that can help ease symptoms while preventing progressive joint damage.

However, if you have advanced damage to your joints and nonsurgical treatments are no longer supporting you throughout your daily activities, an orthopedist may still consider joint surgery as a last resort. Speak with a doctor about the pros and cons of RA joint surgery.