When conservative treatments for osteoarthritis or other types of arthritis fail to satisfactorily relieve pain in the affected joint, it may be time to consider joint surgery. It's important to learn about the various types of joint surgery and understand your options. When most patients think of joint surgery, they think of total joint replacement. But there are other procedures you should know about, including arthrodesis.
Arthrodesis is a surgical procedure which fuses the bones that form a joint, essentially eliminating the joint. The procedure is commonly referred to as joint fusion.
Surgeons implant pins, plates, screws, wires, or rods to position the bones together until they fuse. Bone grafts are sometimes needed if there is significant bone loss. If bone grafting is necessary, bone can be taken from another part of the body or obtained from a bone bank.
Who Is a Candidate for Arthrodesis?
Arthritis patients who have joints so severely damaged that usual pain management techniques fail are candidates for arthrodesis. Depending on which joint is affected, the patient may have the option of joint replacement surgery or arthrodesis. The goals for recovery may be factored into the decision.
The Benefits of Arthrodesis
The primary benefit of arthrodesis is pain relief in the affected joint. By surgically eliminating the joint, pain relief is an attainable goal, barring any complications of surgery.
Consider your goals when deciding if arthrodesis is the best option for you.
- pain relief
- the fused joint is stable again
- patients will be able to bear weight on the fused joint without pain
- improved alignment in patients with severe arthritis
- joint replacement may still be better option for certain patients
- there is loss of flexibility and motion with a fused joint
- slight possibility of wound healing complications
Recovering from Arthrodesis
After surgery, a cast will be placed over the joint that underwent arthrodesis. Until there is x-ray evidence of fusion, use of the operated joint will be limited. The process is a long one. For example, ankle arthrodesis patients are not allowed to bear weight for between 8 to 12 weeks. Patients should keep their leg elevated to decrease swelling and promote healing, until there is evidence of fusion. While the patient needs to be non-weightbearing, crutches or wheelchairs may be very useful.
Arthrodesis is not without potential complications. Pain at the site of bone fusion, nerve injury, infection, or broken hardware (e.g., pins, screws) are known risks associated with arthrodesis. The most troublesome potential complication is a failed fusion, meaning the joint physically does not fuse. Arthrodesis, though, is normally a very successful procedure and serious complications are rare.
Types of Surgery. Arthritis Foundation. Accessed 1/7/08.
Arthritis of the Foot and Ankle. American Academy of Orthopaedic Surgeons. July 2007.