Medication and lifestyle changes may be helpful treatments for controlling psoriatic arthritis (PsA) joint pain and preventing the disease from worsening. But if these aren’t effective in preventing joint damage, your doctor may recommend joint replacement surgery.

“Just finished my second hip replacement, as both were bone on bone due to the arthritis,” one MyPsoriasisTeam member said. “Having that done makes it easier for dealing with hands, feet, neck, and back arthritis — both PsA and osteoarthritis.”

Discover what you can expect if you’re considering joint replacement surgery to treat psoriatic arthritis.

Joint Surgery for Psoriatic Arthritis

Psoriatic arthritis is a type of arthritis that affects about 30 percent of people with the skin condition psoriasis. PsA causes chronic pain and inflammation in your joints. It also leads to damage in the cartilage, bones, ligaments, and synovium (the connective tissue inside a joint).

Some people with severe joint damage and pain may need joint replacement to restore full range of motion and relieve pain in the affected joints. Several types of joint surgery can treat psoriatic arthritis. The type your doctor recommends will depend on which of your joints are affected and the severity of your pain.

Although these procedures can improve quality of life for people with severe forms of PsA — such as psoriatic arthritis mutilans — they don’t treat inflammation.

Types of Joint Surgery for Psoriatic Arthritis

The following are the most common types of joint surgery for psoriatic arthritis:

Synovectomy

A doctor may recommend a synovectomy (removal of the synovium) if your synovium is inflamed and creates too much fluid. This causes cartilage damage, leading to pain and stiffness in the joint. A synovectomy is often done to delay the need for total joint replacement.

Arthrodesis

Arthrodesis surgery entails fusing bones of a joint together in a fixed position. It may be used in people who are in a lot of pain but aren’t candidates for joint replacement surgery. Joint fusion helps stabilize the joint and lessen joint pain, but it can reduce mobility.

Osteotomy

If your joints are out of alignment, your doctor may recommend an osteotomy. The surgery may entail reshaping or moving bone in your joints to improve mobility. In some cases, bone tissue may be added to align the joints.

Debridement

During a debridement procedure, damaged bone tissue found in areas surrounding damaged joints is removed. This procedure may lead to less inflammation in the joints.

Tissue reconstruction

Tissue reconstruction involves repairing ligaments and cartilage in the affected joints.

Arthroplasty

Also called joint replacement, arthroplasty is recommended for late-stage psoriatic arthritis. During this surgery, the damaged joint is replaced by an artificial joint made with durable plastic and metal parts. The most common arthroplasty for people with PsA is total hip replacement, followed by knee replacement.

Joint Replacement Surgery for Psoriatic Arthritis

To prepare for a joint replacement surgery, it’s recommended that you exercise to build muscle strength and lose weight to reduce stress on the joints, if your doctor recommends. “Just strengthen your leg muscles as much as possible beforehand,” one MyPsoriasisTeam member advised another.

On the day of your surgery, you’ll be placed under general anesthesia. This means you’ll be asleep during the procedure. An orthopedic surgeon will make an incision above the joint to be replaced, then remove the damaged bone and cartilage. They’ll insert two metal pieces in place of the damaged joint. Then they’ll put a plastic spacer between the two metal pieces to allow smooth gliding. Finally, the surgeon will close the incision with stitches.

Generally, a person stays at the hospital following surgery for monitoring. You may be prescribed medications to manage pain during recovery. After leaving the hospital, you’ll wear supportive splints to prevent dislocation. If the ankle joint was replaced, you may have to use crutches to reduce the amount of weight on the foot and ankle.

As with all surgeries, there are some risks associated with joint surgeries for psoriatic arthritis. Risks include:

• Infections
• Blood clotting
• Problems with the artificial joint
• Continued pain

In some cases, the stress from the surgery may lead PsA symptoms to worsen.

Recovery and Outlook

In the days after the surgery, you may need assistive and safety devices. These may include a walker, cane, crutches, shower seats, bathroom handrails, elevated toilet seats, and reaching devices. Your doctor will examine how the affected joint is healing in a follow-up visit 10 to 14 days following the surgery. Once the joint heals, doctors recommend four to eight weeks of physical therapy to help with recovery. Recovery time varies depending on such factors as:

• The joint affected
• The activity level you’re returning to
• Your general fitness before the surgery
• The type of surgery
• How well the surgery went

After joint replacement surgery, you should be back to doing most things you love within about three months. Full recovery can take up to two years. In most cases, the artificial joints will last for years. You’ll need to have regular checkups with your healthcare provider to look for wear or other problems.

Joint surgery relieves pain and repairs damaged tissues. This can improve the quality of life in most people with advanced psoriatic arthritis. But, in some cases, bone spurs — hard, smooth bumps of extra bone along bone edges — may form, affecting the structure of the joints. It’s important to properly manage PsA even after surgery to prevent further damage. Here are things you can do:

• Stay active and exercise to strengthen muscles and improve joint stability.
• Maintain a healthy weight, and try to choose foods that reduce psoriatic arthritis inflammation.
• Keep up physical therapy to maintain joint function.
• Continue taking medications as prescribed to control inflammation.

Many MyPsoriasisTeam members have emphasized the importance of staying active, continuing physical therapy, and avoiding things that trigger inflammation. One member shared what has worked with pain relief: “Changing exercise routine, physical therapy adjustments, and finding triggering foods have added a bit more relief.”

A second member said, “Stretching whenever possible and range of motion exercises are musts, even at rest.”

A third member gave this advice: “Staying in one position for a long time affected my back pain, whether at my office desk or on the couch. Stay active — using a smartwatch with a reminder to stand up helped me.”

Managing Postsurgical Pain

Your doctor will talk to you about your options for managing pain after joint replacement surgery. In addition to lifestyle changes and physical therapy, you may be offered pain medicines, such as:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) — These drugs reduce swelling that can lead to pain.
• Opioids — These strong pain medications reduce how you perceive pain and carry the risk of abuse.
• Local anesthetics — These drugs are applied or injected to a specific body site to temporarily relieve pain there.

In the United States, legislation called the NOPAIN Act went into effect in 2025. It aims to expand availability of non-opioid medications to manage postsurgical pain. This may affect which drugs your doctor prescribes. For example, a new non-opioid pain medication was approved in January 2025 to treat moderate to severe acute pain affecting adults.

Talk to your surgeon about which pain management options may be right for you.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people and their loved ones with psoriasis and psoriatic arthritis. Members come together to ask questions, give advice, and share their stories with others who understand life with psoriatic disease.

Have you had joint replacement surgery for psoriatic arthritis? Share your experience and advice in the comments below or by posting on MyPsoriasisTeam.