In some cases, your child may need surgery for their arthritis or arthritis-related condition. These surgeries include joint injections, joint replacement surgery, jaw surgery, cataract surgery, or glaucoma surgery.
Joint injections
Joint injections are injections of corticosteroids (medication) directly into an inflamed joint. This can quickly control inflammation within a joint when other medicines have not worked.
Joint replacement surgery
Joint replacement surgery is not commonly done in young people with JIA. With this type of surgery, the entire joint is replaced with an artificial joint. In young people, this is only done when the joint is severely damaged. Generally, the surgery is not done until a child has stopped growing.
Severe pain in a damaged joint is the usual cause for joint replacement surgery. The most commonly replaced joints are the hips and knees. Joint replacement surgery can help to reduce pain. The surgery can help make the joint function better.
Jaw surgery
This is done to correct jaw deformities such as a small jaw. Surgery usually happens in later adolescence or young adulthood.
Eye surgery
Sometimes eye inflammation can cause the lens to get cloudy. This is called a cataract. Eye inflammation can also cause the pressure inside the eye to become too high. This is called glaucoma.
Surgery for cataracts
There is no medicine to make cataracts go away. If the cataract is making vision very blurry, then cataract surgery may be an option. This is an outpatient operation where the lens of the eye is removed. Some hospitals will put an artificial lens in the eye at that time. However, the insertion of a permanent lens can sometimes cause serious complications. Instead, most hospitals will provide a contact lens to focus the eye after surgery.
Surgery for glaucoma
If eye drops or oral medicine cannot control glaucoma, surgery may be recommended. There are several different types of surgery. All of these are outpatient day procedures.
The goal of glaucoma surgery is to reduce pressure by improving drainage of fluid in the eye.
Both glaucoma and cataract surgery can make eye inflammation worse at first. This is only temporary. Your child may need to increase their steroid eye drops or take some oral steroids around the time of surgery.
Less commonly, an operation may be needed to remove excess calcium on the surface of the eye. This procedure is called band keratopathy. It is done by applying a chemical that washes the calcium away.
