Orthopaedic Trauma Institute, Navicent Health Physician Group

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Essential Facts About the Risks and Benefits of Arthrodesis

Arthrodesis, also referred to as a joint fusion, the uniting of two bones at a joint, is typically completed through surgery. In simple terms, the orthopedic surgeon manually straightens out the damaged joint, removes the cartilage, and then stabilizes the bone so that they heal together. The procedure is typically performed to relieve unrelenting pain that cannot be appropriately managed by traditional treatments, natural remedies, physical therapy, splints, or pain medication.

Reasons for Needing an Arthrodesis

Causes of unrelenting pain that require arthrodesis include osteoarthritis, rheumatoid arthritis, traumatic injuries and fractures that led to disruption of the joint's ability to properly function. This procedure is commonly performed on joints in the foot, ankle, spine, and hand that were damaged by traumatic arthritis from a severe injury. In the past, hip and knee arthrodesis procedures were also completed on a regular basis on a high number of patients. However, with the immense success achieved through the invention of artificial knee and hip joints, the medical community as a primary treatment no longer favors the arthrodesis procedure on these large joints. Rather, replacing the joints with one made from an artificial substance is the surgery of choice.

How is an Arthrodesis Performed?

There are several ways that arthrodesis is performed, and the method selected depends on various factors, such as the patient's overall health, the surgeon's opinion concerning which method is best and the condition of the specific joint where the trauma was sustained.

One way the procedure is completed is through assistance of bone graft. There are two main types of bone graft: one where the bone tissue is from another part of the patient's own body. This is referred to as an autograft. Other times, a donor bone tissue or a synthetically manufactured tissue are used, and the technical term for this type of graft is called allograft.

What is the Recovery Time

Following the surgical procedure, recovery time can take anywhere from a period of several weeks to as long as 12 months. Once the two adjoining bones are completely fused together, the area of bone where the joint was once positioned is no longer capable of motion and typically relieved of pain. Occasionally, additional procedures or more than one bone graft are necessary to complete the healing process. Limited mobility is a permanent result and it is for this reason that arthrodesis is generally used as a procedure of last resort.

Who are Arthrodesis Patients?

Patients that undergo a joint fusion are people in a great deal of pain and these symptoms disrupt their lives. Pain medications no longer work, and life is dramatically restricted. An arthrodesis is worth the loss of motion because the gain in the relief of pain is significant and the treatment is overall restoring function and life. A successful joint fusion relies on the health of the patient. Risk factors such as diabetes, smoking, steroid use, any immunocompromised condition, can increase the risk of complications like infection or a nonunion. However, the orthopedic surgeon will discuss each individual's risks and benefits on a case-by-case basis.

Benefits and Risks of Arthrodesis

Although joint motion is eliminated when joint fusion surgery is performed, the fused joint is no longer painful, the patient can bear more weight more painlessly and typically exhibits greater function. In many instances, patients state that the cessation of unrelenting pain is worth living with somewhat limited mobility. However, as with all surgeries, certain risks are associated with arthrodesis as well.

The risks and possible negative outcomes of joint fusion surgery vary significantly from one patient to the next depending on a variety of factors. These include the person's overall health status, his or her age, and the type of procedure the surgeon plans to perform. Risks include breakage of metal implants, failure of the fusion site, and infection. Continuing pain at the bone fusion site after surgery may also occur, although this complication is less common. Arthrodesis is generally considered a safe procedure and boasts a high success rate among most patients.