Fusion of the joint, otherwise known as arthrodesis is a procedure in which the surfaces of the joint are removed and the bone ends are united. This provides pain relief and stability, but the joint cannot bend.

Lack of mobility is a serious disadvantage of this procedure. Nevertheless, this is the preferred surgery for some younger individuals who have a single involved joint. Mobility in the other joints often will compensate for the loss of movement in the fused joint. The joints most commonly fused are smaller joints, such as those in the toes or fingers.

Younger people with severe arthritis of the hip or knee in whom fusion was once offered, are now considered for total joint replacement, though depending on the individual, a fusion may sometimes be preferable

Osteotomy is an operation in which the surgeon cuts the bone below the affected joint, realigns it, and resets it in a better position. This procedure changes and improves the contact between the remaining healthy areas of cartilage in the joint. Afterwards, the painful areas do not rub against each other.

Osteotomy provides pain relief and leaves the joint mobile; however, it can only be performed in a joint that is not already stiff. Osteotomy usually is reserved for joints with uneven damage. It is not performed frequently, although the procedure sometimes is a good choice for younger arthritis sufferers, since it can prevent further joint damage and postpone the need for joint replacement surgery. (For example, osteotomy of the tibia [shinbone] is performed to correct curvature and weight-bearing in the lower leg of adults with OA of the knee.)

"Scoping" the joint is an expression used to describe arthroscopy - the examination of the inside of a joint using a device equipped with a tiny video camera. By means of arthroscopy, the physician can look for damaged tissue directly within the joint.

A small incision is made through the skin alongside the affected joint. Then, microsurgical tools are used to remove areas of cartilage or cartilage fragments that are causing irritation and thoroughly wash out the joint. Arthroscopy is an outpatient procedure and does not require an overnight stay in the hospital.

Joint "scoping" may provide temporary relief from symptoms - especially those caused by cartilage tears or particles; however, it does not stop the progression of osteoarthritis. It may help for a month in some, six months or much longer in others, and sometimes not at all.

Total joint replacement involves the complete removal of the painful joint, which is exchanged for a man-made appliance. The artificial joint can be fashioned from a combination of materials, including stainless steel, Vitallium™ (a cobalt-chromium alloy), titanium, and high-density polyethylene plastic. Silicone rubber occasionally is used for joint replacements (hand, base of the thumb), if the surgeon elects not to fuse the joint.

The hip and knee have shown the greatest success of all joint replacement surgery. Over 90 percent of people are free of pain and have good mobility following hip replacement surgery for osteoarthritis. Other joints that are less commonly replaced are the shoulder and elbow.

Unfortunately, joint replacements tend to last only 10 to 20 years. But another replacement generally can be performed, if needed. This repeat surgery is called a revision.