Arthrodesis Surgically Relieves Joint Pain

The Pros and Cons of Joint Fusion

Photo by rafost (iStockphoto)

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 a total joint replacement. But there are other procedures you should know about, including arthrodesis.

Arthrodesis Explained

Arthrodesis is a surgical procedure that 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 a significant bone loss. If bone grafting is necessary, bone can be taken from another part of the body or obtained from a bone bank.

Arthrodesis is usually performed on ankles and wrists, but it can be performed on other joints, including thumbs, toes, fingers, and the spine.

Candidates for Arthrodesis

Common candidates for arthrodesis include people with arthritis who have joints so severely damaged that usual pain management techniques fail. Depending on which joint is affected, you 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.

Pros:

  • Stability in the fused joint
  • Significant reduction in pain when weight is borne on the fused joint
  • Improved alignment for severe arthritis

Cons:

  • Joint replacement may still be a better option for certain patients
  • 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 affected joint will be limited. The healing process can take a long time. For example, ankle arthrodesis patients are not allowed to bear weight for between 8 to 12 weeks. You should keep your leg elevated to decrease swelling and promote healing until there is evidence of fusion. You'll need to keep weight off the joint until it's fused, so crutches or wheelchairs will be in your future.

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.

Sources:

Types of Surgery. Arthritis Foundation. 

Arthritis of the Foot and Ankle. American Academy of Orthopaedic Surgeons. July 2007.
http://orthoinfo.aaos.org/topic.cfm?topic=A00209#Surgical%20Treatment

Continue Reading