May 22, 2008

Surgical Treatment Options for Gouty Arthritis

Posted in Category : Bone, Joint & Muscles Disorders

An increase in the levels of uric acid in the body causes the formation of tiny urate crystals that deposit within the tissues and joints of the body. This increase in uric acid levels can be a result of a faulty excretory system or an overproduction of uric acid in the body. Known as gout, these crystal deposits result in flare-ups of joint inflammation or arthritis. Gouty arthritis is a progressive disease and can lead to destruction of the joints and a decreased functioning of the kidneys.

If you suffer from gout, your body is basically unable to process uric acid derived from prurines from the food you eat. Many people may have high levels of blood uric acid but without any crystal deposits or joint pain. This condition is known as asymptomatic hyperuricemia and is regarded as a precursor to gouty arthritis. Gouty arthritis on the other hand includes symptoms such as painful and inflammation as well as redness and heat at the joints. As the disease progresses, attacks recur more often and spread to additional joints.

Treatment for Gouty Arthritis

Treatment for gout aims to reduce inflammation of the joints during an attack and a more long-term approach to prevent further attacks by decreasing the size of crystal deposits in the tissues. Medication can help reduce inflammation and pain during a gout attack. Medications for gout include NSAIDs, corticosteroids, colchicines and adrenocorticotropic hormone (ACTH) as well as painkiller or analgesics. In order to prevent recurring attacks, you also need to make diet changes, maintain a healthy weight and take medications to reduce blood uric acid levels.

Ways To Prevent Gouty Arthritis Attacks

  • Increase your water intake to reduce the risk of kidney stones and help flush out toxins from the body
  • Avoid alcohol if you suffer from gout or hyperuricemia as alcohol increases dehydration and affects blood uric acid metabolism
  • Avoid foods high in prurine such as shellfish, meats, and organ meats
  • Increase your intake of dairy foods as research shows that these products may help reduce gout attacks
  • Items that contain corn syrup such as carbonated soft drinks should be avoided
  • Exercise regularly to maintain a healthy body weight and reduce obesity

Gout and Surgery

In cases where medications and dietary changes do not help reduce gout attacks or the formation of uric acid crystals in the tissues, surgery may be an alternative. Doctors will only consider surgery for gout if the pain is unbearable or the inflammation is constantly increasing. During surgery for gout, the part of the joint where the accumulation of crystal deposits has occurred is removed. In chronic cases, the common areas of gout or crystal deposits are the feet, hands, knees, elbows, and ridge of the outer ears. The tophi or the nodules of crystal deposits that are causing the pain and discomfort are removed.

Removal of this kind may also help prevent cases of dangerous infections of the tophi and improve the range of motion of the joint. Surgery of this kind is not complex and usually involves making an incision over the affected area of the joint removing the tophi. This type of surgery is known as excision surgery and has become a safe and effective way of treating severe cases of gout. Another surgical option for severe cases of gout is joint replacement surgery. This is considered in cases where the crystal deposits have completely damaged the joint and destroyed the cartilage. However, to reach this level of erosion is very rare as in most cases, medication and lifestyle changes successfully control the progression of gout.