The medical and surgical management of patients with rheumatoid disease has improved over recent years. Despite the improvements, much disability and pain arise from the condition. The major surgical advances in recent years have been in the field of joint replacement, and these advances are continuing. Joint replacement units have evolved, allowing further specialization in this rapidly advancing field. Close liaison between the general practitioner, rheumatologist, orthopaedic surgeon and allied health professionals is most important in achieving the best possible results in the management of these patients.