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Medical Author:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Surgery is generally reserved for those patients with arthritis that is particularly severe and unresponsive to the conservative treatments. Surgical procedures can be performed to relieve pain, improve function, and correct deformity. Occasionally, joint tissue is surgically removed for the purpose of biopsy and diagnosis. Doctors who specialize in joint surgery are orthopedic surgeons.

Joint surgery using a viewing tube with a cutting instrument is called arthroscopy. Osteotomy is a bone-removal procedure that can help realign some of the deformity in selected patients, usually those with knee disease. Removal of inflamed joint lining tissue is called synovectomy. In some cases, severely degenerated joints are best treated by fusion (arthrodesis) or replacement with an artificial joint (arthroplasty). "Total joint replacement" is a surgical procedure whereby a destroyed joint is replaced with artificial materials. For example, the small joints of the hand can be replaced with plastic material. Large joints, such as the hips or knees, are replaced with metals. Total hip and total knee replacements are now commonplace. These can bring dramatic pain relief and improved function.

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