Arthrodesis is a surgical procedure, also known as joint fusion. The goal of arthrodesis is to provide pain relief, restore skeletal stability, and improve alignment in people with advanced arthritis.Not all arthritic joints are candidates for joint replacement replacement surgery. Sometimes arthrodesis is the better surgical treatment option for those with arthritis. Arthrodesis is mostly performed on ankles and wrists but it can be performed on other joints.
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
Complications are rare but no procedure is completely free of risk. If you are planning to have arthrodesis,
your doctor will review a list of possible complications which may include:
- Failure of the joint to fuse
- Poor alignment of the joint, causing pain and/or an altered gait
- Need for repeat surgery
- Nerve damage
Factors that may increase the risk of complications include:
- Some chronic diseases
Prior to Procedure
Several nonsurgical methods will be tried to correct your problem before choosing surgery. These may include medications, injections, special shoes, or types of physical therapy. You will have a thorough evaluation to determine your overall health and any risk factors.
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure like:
- Aspirin or other anti-inflammatory drugs
- Blood thinners such as warfarin (Coumadin)
- clopidogrel (Plavix)
Arrange for help at home after returning from the hospital.
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.
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