Arthritis surgery in the Federal Republic of Germany is an established subspecialty of orthopedic surgery. The scientific organization Arbeitgemeinschaft für Rheumaorthopädie (Association for Rheumatic Orthopedics) is an official section of the Deutsche Gesellschaft für Orthopedics and Traumatology) and has very close connections with the European Rheumatoid Arthritis Surgical Society. There are many common activities within this group, especially regarding uniform documentation, which began with the elbow. Furthermore, there are standardized procedures in operative synovectomy, including new trends, e.g., arthroscopic synovectomy. Another special interest is focused on alternatives to endoprosthetic replacement, in particular on resection interposition arthroplasty. With regard to endoprosthetic replacement, the question of cementing or not is controversial; however, there are strong arguments for cementless fixation, especially for hip endoprostheses. Arthritis surgery in Germany reflects modern trends all over the world where rheumatology is a subspecialty bridging the gap between internal medicine and orthopedics.