Surgery

A device called the Prosorba column removes inflammatory antibodies from the patient's blood. It works in the following way:

The blood is first removed from the body through a catheter (a process called apheresis).
The blood is passed through a column about the size of a coffee mug.
The column is coated with a substance called protein A, which binds to the antibodies.
The blood is then returned to the patient.
The procedure lasts for about 2.5 hours. It is performed once a week for 12 weeks.

Studies are reporting that the therapy can slow or even halt the progression of the disease in a third to a half of patients.

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Side effects from the Prosorba column may include anemia, fatigue, itching, fever, a drop in blood pressure, and nausea. Nearly all patients experience an immediate flare-up of joint pain that lasts a few days. Some patients develop infection from the catheter used to remove blood.

Joint Surgeries

Certain surgical techniques may be helpful for people with severe deformities or disabilities.

Arthroscopy. Arthroscopy is performed to clean out bone and cartilage fragments that cause pain and inflammation. It is usually performed on the knee, but it also may be done on the hip:

The surgeon makes a small incision and injects a sterile solution to make the joint swell for easier viewing.
A lighted tube, called an arthroscope (which enables the surgeon to view the joint), is then inserted through another small incision.
Through a third incision, the surgeon trims, shaves, or stitches the damaged tissue. (Arthroscopy is most successful when the removal of cartilage only, and not bone, is involved.)

In many cases, the procedure can be done using local anesthetic, and the patient can go home within a day. In the case of knee operations, patients can resume mild activity in a couple of days, but full recovery can take up to 3 months.

Osteotomy. If only a certain section (the medial compartment) of the knee is damaged and deformed, the surgeon may choose to perform osteotomy: