Can you tell me a little about the kind of surgery they might do for psoriatic arthritis? I have pretty severe joint damage and I’m just starting to explore my options.

Treatment for psoriatic arthritis is individual and really a matter of medical management. In fact, it could be said that “it takes a village” to treat psoriatic arthritis. Dermatologists, rheumatologists, medical doctors, and physical therapists must work together to guide the patient and prevent as much damage as possible.

The specific treatment approach used is based on symptoms and severity of each person’s disease. It is recognized now that early aggressive treatment with medications to control the disease process is important. Medications typically prescribed include antiinflammatories and disease modifying antirheumatic drugs (DMARDs).

New drugs to treat psoriatic arthritis are being investigated by pharmaceutical companies. One of those new treatments is called biologic therapy. This approach uses special immune-blocking agents to stop the inflammatory process at different points in the cascade of events leading to the effects of this disease. Physicians who treat this condition generally agree that patients should explore all conservative options available before having surgery.

If there is severe joint destruction and damage, surgery may be needed to reduce pain and improve function. A variety of different surgical procedures can be used including debridement (cleaning the joint of thick tissue and debris), joint fusion, and joint replacement.

A major concern after surgery is skin infection. The skin lesions called psoriatic plaques often harbor bacteria that can lead to wound infections. Complications from infection can lead to further joint destruction and even systemic infection resulting in death.

Studies reporting the long-term results of surgical management of psoriatic arthritis are limited. In general, there appears to be some improvement in pain and function but stiffness and recurrent, progressive disease are common.