What is arthrodesis?
Arthrodesis, also known as joint fusion, is a surgery that permanently joins two bones at a joint. Joints are the areas where two bones meet, allowing you to move different parts of your body. Your healthcare provider may recommend joint fusion if other treatments haven't helped with severe symptoms like joint pain, stiffness, difficulty moving or poor alignment.
Joint fusion can be performed on various joints in your body, including your:
- Ankles
- Feet
- Spine
- Sacroiliac joints
- Wrists
- Fingers and thumbs
Why might I need arthrodesis?
You might need arthrodesis if you're experiencing joint pain and instability that hasn't been relieved by other treatments. This procedure is often recommended when a joint replacement isn't an option or hasn't been effective.
Some reasons you might need joint fusion include:
- Arthritis of the joints in the arms and legs: Severe arthritis can wear down the cartilage in your joints, causing the bones to rub together.
- Bone fractures: Serious fractures can damage the bones in a joint, leading to discomfort and instability.
- Spine conditions: Conditions like a herniated disk, spondylolisthesis or scoliosis can affect your joints and may require joint fusion for better stability.
- Damaged ligaments, tendons or nerves: When a joint is injured, it can also damage surrounding ligaments, tendons or nerves, which may need fusion to create stability in order to provide improved function and pain relief.
Joint fusion can help reduce discomfort and improve the function of your joint, making it easier to move and live comfortably.
How to prepare for arthrodesis surgery
Preparation for your surgery may depend on which joints are being fused and the type of arthrodesis you will have. Your surgical team will give you detailed instructions to follow as you prepare, but in most cases, you will need to:
- Have a physical exam to ensure you are healthy enough for surgery
- Have blood work done
- Have imaging tests, such as an X-ray, MRI scan or CT scan
- Stop eating the night before and adjust your medications for a dedicated amount of time before surgery
- Try to remain as active as possible before surgery
- Maintain a healthy weight
- Supplement your nutrition as instructed by your surgeon, with such things as a multi-vitamin and protein shakes.
- For a few days before surgery, you likely will be asked to use a special soap while showering and an ointment for your nose to reduce the chance of infection.
The arthrodesis procedure
Orthopedic surgeons can perform arthrodesis using a few different methods, which your surgeon will choose based on the joint, your health and other factors. For example, your surgeon may connect the joint using a bone graft, a piece of bone taken from another part of your body. Your surgeon can also use a manmade material instead of a bone graft, or bone from a donor.
However, the process of achieving an arthrodesis is generally the same, no matter how your surgeon performs the procedure. Your surgeon is essentially directing your body to grow bone where there wasn’t bone before, which joins two separate bones into one.
Before the procedure
You will meet with an anesthesiologist before going to the operating room. He or she will talk to you about how the anesthesia will be administered during the procedure and ask if you have any allergies. Just before surgery, you will receive general anesthesia or a regional anesthesia to completely numb the area around the affected joint.
During the procedure
The length of the procedure itself will depend on which type of surgery you are having. Arthrodesis on smaller joints takes less time than on larger joints. Spinal arthrodesis can take a few to several hours.
Your surgeon will talk to you about what will happen during your exact procedure. In general, to perform arthrodesis, the surgeon will:
- Make incisions around your joint with a surgical tool
- Remove damaged bone or cartilage
- Insert pins, screws, wires or plates into the bones being fused together and secure them in place
- Place a bone graft
- Close the incisions
As you heal, the bones will fuse together, forming one solid bone. This process makes the previously damaged joint stronger, more stable and less painful.
After the procedure
Depending on the type of arthrodesis you have, you may need to stay in the hospital for at least one night. For less complex surgeries, you may be able to go home the same day.
You may receive a prescription for pain-relieving drugs, as discomfort is common during the first few weeks after surgery.
What are the risks of arthrodesis?
All surgeries carry some level of risk, such as infection, pain and bleeding. Like all surgeries, arthrodesis has unique complications that you should discuss with your surgeon before the procedure. They can help you weigh the risks and benefits to determine if arthrodesis is right for you.
Your orthopedic surgeon and the rest of your team will do their best to avoid complications during surgery. However, arthrodesis complications can develop afterward and include:
- Deterioration of nearby joints
- Misalignment of the joints
- Nonunion, which is when joints don’t fuse as they should
- Permanent reduction in the joint’s range of motion
Arthrodesis recovery
Recovery after joint fusion depends on where the fusion is done. For example, healing from finger fusion may take less time than recovery from spinal fusion.
In general, recovery can take from a few months to over a year. Your surgeon will give you an estimated recovery time based on where the fusion was done and your individual situation.
As you heal, you’ll gradually be able to get back to your usual activities. Your surgeon or healthcare provider will tell you when it’s safe to start physical activities again and what movements or positions to avoid during your recovery.