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Surgical Options for Severe Gout

Jan 25, 2015

If you’re suffering from severe gout, you understand how painful and frustrating it can be. Treatment methods may not be working on your gout any longer, or maybe they never worked. Fortunately, there are surgical procedures that can take care of this condition and have you feeling better soon.

Uric acid is produced by the body and is typically excreted as waste. Gout occurs when excess uric acid collects in the bloodstream and crystallizes. When this happens, these crystals are deposited in joints, tendons, and surrounding tissues. Gout can also develop if an individual produces too much uric acid or they can’t excrete the uric acid in their urine. This can be due to poorly functioning kidneys and genetics, but excessive alcohol and certain medications, such as diuretics and low dose aspirin, can also cause uric acid levels to rise. Foods that increase uric acid levels include shellfish, red meat, and foods and drinks high in fructose.

Men between the ages of 40 to 60 are the most susceptible to developing gout, but women don’t typically experience gout until they reach menopause.


Gout causes painful swelling in single joints, most often in the feet and especially the big toe. The second most common joint affected is the knee, but gout can occur in any joint in the body. The pain is usually very intense and can come on strong enough to wake you up in the middle of the night. The joint becomes swollen, red, and warm.

It’s also possible to run a fever when you’re dealing with gout. If this occurs, it’s important to see a doctor immediately because you could have developed an infection.


Mild gout attacks can typically be treated with non-operative methods such as anti-inflammatory medications like ibuprofen and naproxen. These medications will reduce swelling and relieve pain. Corticosteroid injections to the joint or oral tablets can also be an effective way to reduce swelling.

Rest, ice, and elevation are also used to reduce the painful effects of gout. Rest the affected area and try not to move it, apply ice to the joints, and elevate the area above your heart level. This will minimize swelling and provide pain relief.

Surgical Treatment Methods

In some cases, gout becomes too severe to be treated with non-operative methods and surgical treatment becomes necessary. Sometimes, if gout is not recognized or treated right away, it can become much worse and more painful.

Tophi Removal – In advanced gout, the tophi, or large nodules of uric acid crystals surround the affected joints, tendons, or bursae. In some cases, the nodules break open and can become infected. If this swelling persists and doesn’t decrease with treatment, surgical removal is usually required.

Joint Fusion – In some cases, gout destroys the joint so that it no longer works properly. Fusing smaller joints together will limit movement and relieve pain.

Joint Replacement – During this procedure, the joint affected by gout is removed and replaced with artificial parts to relieve pain and improve function.

It’s important to treat gout when you first notice the symptoms. Ignoring the signs and symptoms can lead to severe gout that can only be treated with surgical methods. If you believe you need to undergo surgery for gout, download our e-book, How to Choose an Orthopaedic Surgeon. This educational guide will provide you with all you need to know about finding a reputable surgeon to perform your procedure.