I saw another surgeon today for a second opinion on my PsA joint problems with my arms.   Finger, thumb, wrist joint space is ok for now but incredibly painful for some reason???   Elbows are a different thing:   no joint space, bone on bone, surfaces are so badly damaged an arthroscopy is not possible.   My only options are bilateral total elbow replacement or pain management.  Sounded good at first then I looked into it and spoke with two surgeons:   20% are not successful and only last around 5 years, second replacements aren't as successful.   After replacement, no lifting anything heavier than a coffee cup, no repetitive , hammering or jerking movements.   So, sit in front of a TV and use the remote carefully for the rest of my life.   The other option?   Manage the pain until I can no longer stand it, pretty close to that now actually, I use two hands for a coffee, the wife washes and dries me, clothes me on occasion and I eat Dmards, painkillers like Smarties.   There's a lesson in this:   never, never exercise, pick your parents very, very carefully, always expect the worst and most importantly 'do not, repeat, do not grow old, die young and healthy!