Arthritis Foundation Logo
Español ES
Your Local Area
Sign In
Popular Search
arthritis gout home ja
Suggested Content
Article
Rx for Access
Online resource that helps patients better understand health coverage options, choose the right coverage, manage the denial process and reduce health care costs.
Article
Do I Have Arthritis?
Think you may have arthritis? Learn about the four most common warning signs.
Article
Gout
Gout is an inflammatory type of arthritis that can come and go.
Arthritis Foundation Logo
  • About Arthritis
    Common Topics
    woman holding her wristWhat Is Arthritis?

    Arthritis is not one disease. Learn about the different types of arthritis, how they differ and why it’s important.

    microbesInflammation and the Immune System

    Body-wide inflammation is at the root of most chronic diseases — and you may have more control over it than you think.

    Patient talking with nurseNewly Diagnosed With Arthritis

    A new arthritis diagnosis can be overwhelming. These tips can help.

    • Understanding Arthritis
    • Arthritis Types
    • More About Arthritis
    • Where it Hurts
    • Related Conditions
  • Treatments
    Common Topics
    Woman holding shoulderWebinar: Touch Therapies for Pain Management

    Learn the evidence behind popular touch therapies for arthritis, including what to try and what to avoid, for how long and when.

    Managing Arthritis Care Costs

    Learn the basics about health care costs and financial tools available to you.

    Man with head in hands on bedWebinar: Arthritis Fatigue Causes and Solutions

    Learn the various causes of arthritis-related fatigue and strategies to combat weariness.

    • Treatment Plan
    • Drug Guide
    • Joint Surgery
    • Complementary Therapies
    • Insurance Management
  • Healthy Living
    Common Topics
    Woman with upset stomachMicrobiome, Gut Health & Arthritis

    Microbiome, microbes, microorganisms – these terms may be confusing, but the types of bacteria living in and on our bodies can impact arthritis. Learn what helps or harms the microbiome and the health of your gut and discover dietary changes that can make a difference. This episode was originally released on January 19, 2021.

    man exercisingStairs Workout Demo

    Strengthen your leg muscles and improve your stability to make going up and down stairs safer and easier.

    woman consoling anotherArthritis and Mental Health

    Learn about the connection between arthritis, depression and anxiety and how these conditions can make your arthritis worse.

    • Ease of Use Products
    • Managing Pain
    • Recipes & Nutrition
    • Physical Activity
    • Emotional Well-being
    • Daily Living
    • Family & Relationships
  • Juvenile Arthritis
    Common Topics
    2023 JA Family Summit

    Learn about the National Juvenile Arthritis Conference, a place for families to connect, share and learn.

    JA Camps

    The Arthritis Foundation’s JA camp programs give kids with arthritis and related childhood rheumatic diseases the chance to make lasting memories.

    Juvenile Arthritis Volunteer

    • About Juvenile Arthritis
    • Treatment
    • Managing Pain
    • Medical Decisions
    • Nutrition
    • Emotional Well-being
  • Professionals
    Common Topics
    Transforming Clinical Interactions

    The Live Yes! Arthritis community connects patients with others online and in-person for support and education, and encourages patients to play an active role in their health care.

    Partners 4 Patients with Arthritis

    The Arthritis Foundation recently launched an initiative to build stronger relationships and increase recognition of our most engaged practices. 

    Fellowships

    See how we're aiming to address the growing shortage of arthritis specialists, especially in under-served parts of the country.

    • Better Living Toolkits
    • Our Issue Briefs
  • Science
    Common Topics
    OACS Forum Series

    The Osteoarthritis Clinical Studies Forum Series features OA thought leaders from across the globe discussing the future of how the disease can be treated to improve patient outcomes.

    man bandaging boy's kneeConquering Childhood Arthritis

    The Arthritis Foundation is mobilizing patients and their families to engage in studies comparing the effectiveness of treatments for juvenile arthritis and funding research for more options.

    Focus

    • Awards
    • Funding Opportunities
    • OACS Forum Series
    • Osteoarthritis Focus
    • Participate in Clinical Trials
    • Partnerships
    • Publications
  • Get Involved
    Common Topics
    Capital hillAction Center

    Take action today - use the resources here to learn who your elected officials are, what opportunities we have to advocate from the comfort of your own home, federal and state legislation, and more!

    LiveYes! Insights thumbnailLive Yes! INSIGHTS

    Share your experience in a 10-minute assessment to be among those changing the future of arthritis.

    woman listening to podcastLive Yes! Podcast

    You may have arthritis, but it doesn't have you. The Arthritis Foundation’s one-of-a-kind podcast. Hosted by patients, for patients.

    • Advocacy
    • Ways to Give
    • Fundraising
    • Volunteer
    • Partnership
    • Live Yes! Arthritis Community
Donate
Back

When Your Child With JIA Needs Surgery

Although surgery is not common in children with arthritis, sometimes it is necessary. Here's what you need to know.

By Mary Anne Dunkin | Updated April 27, 2022

In the last few decades, the need for surgery for juvenile idiopathic arthritis (JIA) has been dramatically reduced. Thanks to the emergence and more aggressive use of powerful drugs, your child faces a much lower risk of developing joint damage that’s substantial enough to require some type of surgical intervention. “We used to see children with severe joint destruction of multiple joints including both hips and knees, but now we rarely see those patients. The patients we do see typically are older than before and have oligoarticular disease-affecting one or two joints,” says Mark P. Figgie, MD, chief emeritus of the Surgical Arthritis Service at Hospital for Special Surgery (HSS).

By combining medication with other tools — such as regular stretching and exercise to prevent joint contractures, and assistive devices, such as splints, to support or reposition weakened joints — your child’s joints can be protected for a longer period of time and functional challenges reduced or prevented.

Still, surgery sometimes becomes unavoidable usually for one of two reasons: Either medication couldn’t stop the progression of joint damage, or your child was diagnosed later in the disease after significant damage had occurred. In such cases, surgery may provide pain relief and restore function.

The following tend to be the most commonly performed surgical procedures on children with arthritis.

Epiphysiodesis

The knee joint has growth plates that increase the length of the leg as kids grow. Arthritis can sometimes cause too much or too little growth in the growth centers of the leg bones, leading to a discrepancy in leg lengths. Epiphysiodesis is a surgery that stops or slows growth in the longer leg, allowing the shorter leg to catch up over time.

Why it’s done: To correct a difference in leg lengths.

How it’s done: There are several ways to perform epiphysiodesis. Some are permanent and others are temporary (called hemiepiphysiodesis) and reversible. A common surgery uses metal plates to temporarily halt bone growth in the longer leg. Permanent epiphysiodesis removes part of the growth plate. Both types of surgery require precise timing and the ability to correctly predict how much more the longer leg will grow.

What else you need to know: Epiphysiodesis usually is reserved for children whose anticipated leg-length discrepancy is greater than 2 centimeters (or almost an inch) and who have at least one to two years of growth remaining. The recovery period is brief, with few complications, though the screws used to fasten the metal plates can loosen, and a temporarily corrected leg can sometimes revert to its previous length. Epiphysiodesis can also cause kids to be slightly shorter than without the surgery.

Joint Fusion (arthrodesis)

In this procedure, also called bone fusion, the surgeon removes damaged cartilage from the ends of two bones that form a joint and then positions the bones together and holds them in place with a pin or rod. Over time, the two bones fuse to form a single unit, much as a broken bone fuses when it heals.

Why it’s done: The main goal is to relieve severe pain by stopping the joint from moving.  Arthrodesis can also make a joint more stable and help it bear weight better. It’s usually performed on joints in the foot and ankle, hand and wrist, or spine.

What else you need to know: Once a joint is fused, your child will not be able to bend it. Sometimes the bones may not fuse or the wound might not heal properly. Arthritis can also develop in nearby joints because of increased stress from the fusion. The surgery is painful and it may take months to fully recover. Be sure you and your child understand the risks and benefits of this type of surgery.

Synovectomy

This procedure removes excess synovial tissue. The synovium is normally a thin membrane that lines the joint capsule. With chronic inflammation of this lining (as occurs with juvenile arthritis), it not only produces extra fluid, but grows much thicker and can affect joint structure and function. The vast majority of synovectomies are performed by arthroscopy, a procedure in which surgical tools are inserted through a few small incisions, eliminating the need to open the joint.

Why it’s done: Synovectomy is designed to remove excess synovial lining that isn’t responding to treatments, including corticosteroid injections into the joint. The procedure is usually performed on the knee and occasionally the wrist and elbow.

What else you need to know: Although synovectomy can relieve pain and swelling, it doesn’t stop progression of the disease. In most cases, the synovium grows back in a matter of months or years, depending on the response to medications. For some children, joint pain and swelling are so severe that surgery is worthwhile for even a short period of relief. If it’s successful, the procedure can be repeated when the synovium grows back.

Osteotomy

This surgery helps correct a bone deformity by cutting and repositioning the bone and then resetting it in a better position. It’s usually performed on the knee, hip, foot and temporomandibular joint (TMJ) in the jaw.

Why it’s done: Correcting bone deformities helps maintain the proper anatomy and function of the joint. For kids with TMJ disease, osteotomy can improve facial structure and self-confidence and make eating and chewing easier. Small studies of outcomes in TMJ surgery have shown positive results in kids whose facial growth is complete — 15 years for girls and 17 to 18 years for boys. Performing surgery sooner is likely to lead to repeat operations.

What else you need to know: Osteotomy is generally low-risk and safer than total hip or knee replacement. Post-surgery recovery for kids with jaw deformities can be rough; they wear elastic bands to support the jaw, use a palatal splint and eat a soft diet for a few months. But for most, the life-altering changes they experience are worth it.

Total joint replacement (arthroplasty)

This surgery involves removing a damaged joint and replacing it with an artificial ceramic or plastic joint.

Why it’s done: Although common in older adults, this surgery is considered a last-ditch option for kids with JA. It’s usually reserved for joints that are so severely damaged, painful and stiff that they interfere with a child’s functioning and quality of life. The most commonly replaced joint is the hip, followed by the knee.

What else you need to know: Total joint replacement in children tends to have a number of drawbacks and complications. Replacing joints can stunt growth, and the longevity of prosthetic joints is limited. Although doctors delay the surgery as long as possible for young people, one or more repeat surgeries are usually needed. Second and third surgeries are far more challenging and less successful than the original joint replacement. Complications can include premature failure of the synthetic joint, deep infections that could potentially require more surgery, bone perforation and joint dislocation.

Joint Surgery
View All Articles
Understand Your Joint Surgery Options

Joint Surgery

Understand Your Joint Surgery Options
Joint surgery in your future? Read about the most common surgeries and which may be right for you.
Read More
Making Sense of Your Insurance
Choose the right coverage, reduce costs and minimize claim denials with these helpful tips.
Get Started
Give & Get Your Best
Your gift does amazing things for the Live Yes! Arthritis Community. Help yourself and help others.
Donate
Stay in the Know. Live in the Yes.

Get involved with the arthritis community. Tell us a little about yourself and, based on your interests, you’ll receive emails packed with the latest information and resources to live your best life and connect with others.

 
Get Involved
  • Live Yes! Arthritis Community
  • Live Yes! Connect Groups
  • Live Yes! Online Community
  • Local Office
  • Fundraising
  • Webinars
  • Volunteer Portal
  • Store
About
  • About Us
  • Annual Report
  • Careers
  • Code Of Ethics
  • Financials
  • News and Stories
  • Privacy Notice
  • Terms of Use
  • Español
Join Us
  • Jingle Bell Run
  • JA Camps
  • Pathways Conference
  • Walk to Cure Arthritis
  • Fundraise Your Way
  • JA Family Summit
Home Office
  • 1355 Peachtree St NE Suite 600
  • Atlanta, GA 30309
  • Helpline: 1-800-283-7800
  • Contact Us
Ashburn, VA
63° Arthritis Index At Extreme Risk
See More Details
Arthritis Foundation is a qualified 501(c)(3) EIN 58-1341679
I Want to Contribute
I Need Help
  • Donate

    Donate

    Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life.

  • Volunteer

    Volunteer

    Join us and become a Champion of Yes. There are many volunteer opportunities available.

  • Live Yes! INSIGHTS

    Live Yes! INSIGHTS

    Take part to be among those changing lives today and changing the future of arthritis.

  • Partner

    Partner

    Proud Partners of the Arthritis Foundation make an annual commitment to directly support the Foundation’s mission.

Donate


Ways to Give

Every gift to the Arthritis Foundation will help people with arthritis across the U.S. live their best life. Whether it is supporting cutting-edge research, 24/7 access to one-on-one support, resources and tools for daily living, and more, your gift will be life-changing.

Make a Donation

Help millions of people live with less pain and fund groundbreaking research to discover a cure for this devastating disease. Please, make your urgently-needed donation to the Arthritis Foundation now!

Become a Member

Become an Arthritis Foundation member today for just $20 and you'll receive access to helpful tools..... and more. 

Make a Honor or Memorial Gift

Honor a loved one with a meaningful donation to the Arthritis Foundation. We'll send a handwritten card to the honoree or their family notifying them of your thoughtful gift.

Gift Planning

I want information on ways to remember the AF in my will, trust or other financial planning vehicles.
 

Other Ways to Give

  • Match Gift
  • Donate a Car
  • Donor-Advised Funds

Volunteer


Volunteer Opportunities

The Arthritis Foundation is focused on finding a cure and championing the fight against arthritis with life-changing information, advocacy, science and community. We can only achieve these goals with your help. Strong, outspoken and engaged volunteers will help us conquer arthritis. By getting involved, you become a leader in our organization and help make a difference in the lives of millions. Join us and become a Champion of Yes.

Become a Volunteer

More About Volunteering

  • Walk to Cure
  • Jingle Bell Run
  • Do it Yourself Fundraising
  • JA Camp
  • Start a Live Yes! Connect Group
  • Be an Online Community Moderator
  • Local Leadership Board

Live Yes! INSIGHTS


Give Just 10 Minutes.

Tell us what matters most to you. Change the future of arthritis.

By taking part in the Live Yes! INSIGHTS assessment, you’ll be among those changing lives today and changing the future of arthritis, for yourself and for 54 million others. And all it takes is just 10 minutes.

Your shared experiences will help:

- Lead to more effective treatments and outcomes
- Develop programs to meet the needs of you and your community
- Shape a powerful agenda that fights for you

Now is the time to make your voice count, for yourself and the entire arthritis community. 

Currently this program is for the adult arthritis community.  Since the needs of the juvenile arthritis (JA) community are unique, we are currently working with experts to develop a customized experience for JA families. 

How are you changing the future?

By sharing your experience, you’re showing decision-makers the realities of living with arthritis, paving the way for change. You’re helping break down barriers to care, inform research and create resources that make a difference in people’s lives, including your own.

Get Started

Partner


Meet Our Partners

As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability. Join us today and help lead the way as a Champion of Yes.

Trailblazer

Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. They contribute $2,000,000 to $2,749,000

Visionary

Our Visionary partners help us plan for a future that includes a cure for arthritis. These inspired and inventive champions have contributed $1,500,00 to $1,999,999.

Pioneer

Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. They contribute $1,000,000 to $1,499,999.

Pacesetter

Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis. They contribute $500,000 to $999,000.

Signature

Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis. They contribute $250,000 to $499,999.

Supporting

Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. They contribute $100,000 to $249,999.

More About Partnerships

  • Partner with Us
  • Ease Of Use Commendation
  • Let's Get a Grip On Arthritis
  • Promotions that Give Back