Reconstructive Plastic Surgery

Rheumatoid Arthritis and Osteoarthritis

Arthritis can occur in many forms and can be crippling. Modern medications have been very effective at managing conditions like rheumatoid arthritis (Disease Modifying Anti-Rheumatoid Drugs- DMARDs) with little surgical input. Despite these therapies, surgery can still be necessary to restore normal mechanics to the hand and to limit further function loss from joint destruction.

Osteoarthritis is a more common condition, mostly affecting the base of the thumb and the small joints of the fingers. Surgery can play an important role in managing osteoarthritic hands when non-operative management is no longer able to maintain appropriate hand function without significant pain.

We will undertake a thorough history and examination to determine the nature of any arthritis and its impact on your hands. Medical imaging may assist in this process.

We will then work with you to determine your goals and whether surgery will play a part in improving your hand function and quality of life.


What types of surgery does my RPS surgeon do for arthritis?

  • Arthrodesis: involves fusing (joining) the two bones forming the joint together. As the fused joint cannot be moved it is no longer painful. This type of surgery is most commonly done on ankles, wrists, fingers or thumbs.
  • Resection: is the removal of part or all of a bone or an entire joint. This is often done for damaged joints in the foot and big toe.
  • Synovectomy: is an operation to remove the lining of the joints, the synovium. This is effective for rheumatoid arthritis, to reduce pain, swelling and joint damage. However the synovium may regrow several years later and the symptoms can return.
  • Joint replacement: is also called arthroplasty. This involves the removal of damaged surfaces of the joint. These surfaces are then replaced with metal, ceramic or plastic parts. The entire joint can be replaced (total arthroplasty) or just one part of the joint (hemiarthroplasty). Joint replacements can be done on knees, hips, shoulders, elbows, fingers, ankles, toes and even the spine.

All of these surgeries are best performed when non-operative management (including management by a specialist Rheumatologist for rheumatoid arthritis) and medications are already optimised and there is an agreed plan for surgery to help with specific issues within the hand as part of on-going non-operative management approaches.

Is there anything I can do to help prepare for surgery?

  • Plan for recovery and returning home. During your recovery, which may take days, weeks or even months, you may need help with daily tasks such as cooking and showering. Make sure you have family and/or friends available to help you during this time. If you do not have help available, talk to your doctor about local support services or staying at a rehabilitation centre after surgery.
  • You may be required to attend an assessment at the hospital before your surgery. This is a good chance for you to ask questions about your surgery and recovery. Also you may be able to talk to a physiotherapist or occupational therapist about any equipment you may need, such as crutches and handrails in the shower.
  • Lose weight if you are overweight.
  • Stop smoking.
  • Start an exercise program. People with greater fitness and muscle strength usually recover more quickly from surgery. If you have severe pain, you may find water exercise more comfortable. See a physiotherapist for hydrotherapy or contact your local Arthritis Office for details of warm water exercise classes.
  • You will probably need to follow a physiotherapy or exercise program after surgery. Be ready for several weeks or even months of exercise. Remember, the amount of effort you put into your program can make a big difference in how well you recover.
How will RPS manage my post-operative care?

Your RPS team will give you specific advice regarding your individual post-operative recovery. They will advise:

  • where you will go after your surgery
  • what medication you will be given or prescribed
  • what bandages and dressings you will need and when they’ll be removed
  • if you require stitches, when they’ll be removed
  • when you can get back to normal activity and exercise
  • when to book your follow-up care.
  • Contacts for Hand Therapy, oedema management and splints as necessary.
Why do people with arthritis have joint surgery?

Most types of surgery for arthritis are performed to:

  • relieve severe pain that has not responded to other treatments
  • improve movement and use of a joint, for example improve flexibility of your hip to allow you to walk and sit more comfortably
  • improve alignment (position) of joints, for example straighten finger joints to allow you to grip and hold objects.

This can help make daily activities easier and improve your quality of life

When should I talk to my doctor about joint surgery?

If you have any of the following signs you should talk to your doctor about the possibility of surgery.

  • You have pain that stops you going to sleep at night.
  • Your pain does not improve with rest, medicines, exercise or other treatments.
  • Your affected joint makes it difficult for you to look after yourself (such as showering, getting dressed, preparing meals, getting out of a chair) and you require help from others for everyday tasks.
  • Your condition makes it difficult for you to work or look after people who require your care.
    • Your pain is keeping you from doing things you enjoy, such as exercising or doing hobbies.
Our Canberra specialists

The team at RPS Canberra are committed to providing you with the best possible outcome.

The extensive specialist skills of our surgical team ensure that you are provided with surgical options designed to maximise form and function.

Our surgeons hold an impressive array of academic credentials, extensive professional experience and a personal commitment to patient satisfaction.