In cases of systemic diseases such as arthritis, the choice of surgical treatment places demands upon the physician. Any organ system may be involved; not only joints, but also the skin, bone marrow, kidneys, and the vascular or nervous systems. The cervical column is often affected; the elasticity of connective tissue is reduced, and osteoporosis is a predominant feature. The medication used is potent. Surgical treatment of arthritis is of two main categories: reconstructive surgery, which accounts for 60-80 per cent of cases; and synovectomy, for its inhibitory effect on joint destruction, which at most clinics is used in 20-40 per cent of cases.