Tophi gout removal: Causes, treatment, and aftercare

There are currently three surgical options for people with more advanced cases of gout: tophi removal, joint fusion, and joint replacement. However, this article, Zextrasure will focus solely on the tophi gout removal method to help you better understand how to treat gout when it has progressed to a severe stage. Keep reading for detailed information below!

1. What is tophi gout removal? 

Typically, gout can be managed effectively with medication and a healthy lifestyle. It helps to prevent the disease from progressing and reduces the pain recurs. However, if left untreated or poorly managed for about 10 years, gout may advance to a chronic stage characterized by the formation of tophi.

Tophi are deposits of uric acid crystals that accumulate in connective tissues over the years. These deposits are commonly found around joints and soft tissues near the joints in people with gout. They appear as small or large lumps under the skin, with their size varying from patient to patient. The presence of tophi indicates that gout has become chronic and has persisted for a long time.

If not treated promptly, chronic gout can lead to serious complications like joint damage that may result in disability.

Tophi gout removal is a surgical procedure to eliminate these hardened, chalky uric acid deposits that form under the skin in advanced gout cases.

Gout when it progresses to the stage where tophi appear

2. Why you need tophi gout removal

The surgical removal of tophi is extremely necessary as they can directly impact your health. Below are some reasons you should know about this procedure:

• Pain and discomfort: Tophi can grow large and press against surrounding tissues or nerves, causing persistent or severe pain. Inflamed tophi can exacerbate pain, especially during gout flare-ups, making it difficult to focus on daily tasks or rest comfortably.
• Joint damage: Over time, untreated tophi can erode cartilage, bones, and other structures within the joints. This damage may lead to deformity, joint instability, and permanent loss of function, even with medical treatment. Tophi gout removal helps prevent or minimize further joint degeneration.
• Reduced mobility: Large or numerous tophi can interfere with joint movement, reducing the ability to perform basic activities like walking, bending, or gripping objects. 
• Aesthetic concerns: Tophi often appear as visible lumps under the skin, particularly on fingers, toes, or elbows. These unsightly lumps can affect your confidence and self-esteem, especially if they are prominent or easily noticeable to others.
• Infection risk: In some cases, tophi can become infected, leading to complications such as abscesses or open sores. Infected tophi may require urgent surgical intervention to avoid risks like sepsis or other severe medical conditions.

When tophi appears, gout can lead to many serious health complications

See other:

• The last stages of sciatica: Symptoms, treatment, recovery

• Is gout hereditary? Exploring the genetic factors

3. When is gout needed tophi gout removal

tophi gout removal is performed when the deposits are large, numerous, or cause serious complications such as infections, ulcers, or ruptures. In cases where the joints are severely damaged, leading to deformities and limited mobility, joint replacement surgery may be necessary to preserve the patient’s ability to move.

For smaller tophi, the primary treatment approach involves using medication to dissolve and reduce their size. Drugs like allopurinol, febuxostat, probenecid, or pegloticase are commonly prescribed to lower uric acid levels in the blood, gradually eliminating the tophi.

4. Surgery crystals gout removal

Tophi gout removal involves the physical extraction of urate deposits, also known as tophi, that have formed due to chronic gout. The procedure is generally considered when gout crystals cause severe pain, deformities, or complications that cannot be managed with medication or lifestyle changes.

The implementation process includes the following steps:

• The surgeon makes an incision to remove the tophi.
• Often performed under local or general anesthesia, depending on the size and location.

Surgery crystals gout removal

5. Recovery after surgery to remove gout tophus

Tophi gout removal is a minimally invasive procedure that typically involves a quick recovery period. Here's a breakdown of what you can expect:

Immediate Post-Surgery

• Pain Management: You'll likely experience some pain and discomfort at the surgical site. Your doctor will prescribe pain medication to manage this.  
• Dressing: A bandage will be applied to the surgical site to protect it from infection.  
• Elevation: Elevating the affected area can help reduce swelling.

Short-Term Recovery (1-2 weeks)

• Healing: The surgical wound will gradually heal, and any stitches or staples will be removed.
• Pain Reduction: The pain should subside significantly as the wound heals.
• Limited Activity: You'll need to avoid strenuous activities and heavy lifting during this period.

Long-Term Recovery (2-6 weeks)

• Full Healing: The surgical site should be completely healed by this point.
• Return to Normal Activities: You can gradually resume your normal activities, including exercise.
• Managing Gout: It's crucial to continue managing your gout condition to prevent the formation of new tophi. This may involve medication and dietary changes.  

During recovery after tophi gout removal surgery, you need to take accompanying medications

6. Potential complications to watch for when doing tophi gout removal

Although complications are uncommon, be aware of:

• Infections: Signs include redness, warmth, discharge, or fever.
• Delayed healing: Common in patients with diabetes or other chronic conditions.
• New tophi formation: This can occur if uric acid levels remain high.

7. Gout removal surgery cost?

The cost of tophi gout removal surgery can vary depending on several factors, including:

• Location: The cost of the procedure may vary depending on where you live and the specific healthcare facility you choose.
• The severity of the condition: The size and number of tophi to be removed can affect the overall cost.
• Type of anesthesia: The type of anesthesia used during the procedure, whether local or general, can also impact the cost.
• Additional services: Any additional services required, such as laboratory tests or post-operative care, can add to the total cost.

The cost for this procedure can be estimated as follows:

• Simple tophi gout removal: $3,000–$10,000 per procedure.
• Complex surgeries involving joints or multiple tophi: $10,000–$20,000 or more.
• Joint replacement (if needed): $20,000–$50,000 depending on the joint and the prosthesis used.

With advancements in medical technology, tophi gout removal surgery has become safer and more effective than ever before. If you're experiencing discomfort caused by tophi, consult your doctor to find the most suitable treatment plan