The clinical presentation of rheumatoid arthritis is characterized by invasion of multiple joints, with the onset often bilateral, symmetrical and polyarticular. Morning stiffness is a typical manifestation of rheumatoid arthritis. Patients wake up in the morning with a feeling of tightness and stiffness in the joints, which can last for an hour or even a whole day. The disease can affect any joint, starting with the small joints of the hands and feet, while the wrists, elbows, knees, ankles and other joints can also be involved. When the elbow, shoulder, knee, hip and other joints of the body are involved, joint swelling, pain, restricted movement and contracture deformity may occur, which seriously affects the life and work of patients. The treatment of rheumatoid arthritis is divided into two categories: medical treatment and surgical treatment. Internal treatment includes medication, diet, physical therapy, education and rest. Systematic medication is fundamental to the treatment of rheumatoid arthritis. Classical medications include NSAIDs, slow-acting antirheumatic drugs, glucocorticoids and biologics. Current overall strategies regarding the use of medications include several different modalities for the clinician to choose from depending on the patient’s situation. Surgical treatment includes 1. Synovectomy: The pathological basis of rheumatoid arthritis is synovitis, so the early stage of the disease is mostly accompanied by synovial inflammation and hypertrophy of the joint, especially in the knee, when there is no or only mild cartilage and bone changes and destruction. If synovitis is not effectively controlled after six months of systematic conservative medical treatment, synovectomy should be performed promptly to protect the articular cartilage from inflammatory synovial erosion. There are three types of synovectomy: (1) open synovectomy; (2) arthroscopic synovectomy; and (3) non-surgical synovectomy with radioactive drugs. Currently, the first two methods are mostly used. Intraoperatively, dark red synovial hyperplasia edema is seen, mostly located in the suprapatellar capsule, intercondylar fossa and medial and lateral intercondylar sulci, and part of the synovial membrane is attached to the cartilage surface, and the cartilage beneath it is sometimes thinned or partially exfoliated after removal of the synovial membrane. The synovial area of the whole body is about 1000 cm 2 , and the knee is the largest synovial joint in the human body. The synovial area of both knees is about 500 cm 2 , accounting for about half of the synovial area of the whole body. Surgery removes a large amount of diseased synovial membrane, removes the target tissue for rheumatoid factor attack, and reduces the release of disease-causing factors into the blood circulation, which is beneficial to the improvement of the whole body and reduces the degree of involvement of other organs in the body. At the same time, anti-rheumatoid drugs are more focused on other joints throughout the body, to reduce the development of the disease to a certain extent. 2.Arthroplasty: In the early stage of arthritis, for those joints with little synovial membrane, as well as those joints where the destruction of bone and cartilage is not mainly caused by synovial membrane lesions, but secondary arthritis caused by deformities, such as rheumatoid hand, foot, shoulder, elbow deformities, etc., arthroplasty can be used to improve joint function. 3, artificial joint replacement: rheumatoid arthritis in the late stage, the joints appear obvious inversion and flexion contracture deformity, especially the hip and knee and other important weight-bearing joints, resulting in serious loss of function, walking can not, long-term bedridden or even unable to take care of themselves. Only through artificial joint replacement can patients restore joint function and relieve pain. Artificial joint replacement for patients with rheumatoid arthritis has several challenges compared to osteoarthritis. (1) Osteoporosis. Patients have severe osteoporosis due to long-term bed rest and corticosteroid use, so careful operation is required to prevent fracture. ② Adrenal cortical function crisis. The patient’s long-term use of exogenous corticosteroids has led to significant atrophy of his own adrenal cortex. If hormonal protection is not given intraoperatively and postoperatively, there is a risk of cortical function crisis. (iii) Postoperative long-term joint infection. According to statistics, the risk of infection in patients with rheumatoid arthritis after total knee replacement is 2.7 times higher than that in patients with osteoarthritis. Therefore, preoperative and postoperative infections should be actively prevented, and patients should be advised to pay attention to the prevention and control of infectious foci in other parts of the body outside the hospital. Artificial joint replacement has greatly improved the quality of life of patients with advanced rheumatoid arthritis and has given them a new lease of life. However, since the rheumatoid disease itself is not cured, patients still need to receive regular medical system treatment after surgery.