Arthrodesis, commonly known as joint fusion, is a surgical procedure designed to permanently unite two bones that typically form a movable joint. Its primary objective is to alleviate persistent pain and provide stability to a compromised joint. This procedure is often considered when other treatments have not provided sufficient relief for joint conditions.
Understanding Arthrodesis
Arthrodesis involves fusing two bones within a joint into a single, solid bone. This requires removing the joint’s cartilage, bringing the prepared bone surfaces into direct contact to promote biological fusion. While fusion results in permanent loss of motion at the treated joint, it aims to eliminate pain and significantly enhance its stability.
When Arthrodesis is Performed
Arthrodesis is typically recommended for individuals experiencing severe joint pain, instability, or deformity that has not improved with less invasive treatments. Common conditions leading to this procedure include severe arthritis, such as osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis, where cartilage has deteriorated, causing bone-on-bone friction. Joint instability due to ligamentous injury, severe fractures that damage the joint, or certain genetic and neuromuscular conditions can also necessitate fusion. This surgery is frequently performed on joints in the spine, ankle, foot, wrist, and fingers, where the benefits of pain relief and stability often outweigh the loss of motion.
The Surgical Procedure
The arthrodesis procedure generally begins with the administration of anesthesia, which can be general or regional, to ensure the patient’s comfort. The surgeon then makes an incision to access the affected joint, removing any damaged cartilage and preparing the bone surfaces for fusion. To facilitate bone growth and fusion, bone grafts may be used; these can be autografts, taken from the patient, or allografts, derived from a donor. Metal hardware, such as plates, screws, wires, or rods, is then precisely inserted to hold the bones firmly in place while they heal and fuse together. This internal fixation provides stability for the bones to consolidate over time.
Life After Arthrodesis
Following arthrodesis, the initial recovery phase involves managing pain and immobilizing the fused joint with a cast or brace for healing. Bone fusion is a biological process that can take several weeks to many months, typically ranging from 6 to 12 weeks for initial fusion and up to a year for complete consolidation. Physical therapy and rehabilitation are important for recovery, focusing on strengthening surrounding muscles and adapting to the permanent loss of motion in the fused joint. While the fused joint will no longer bend, individuals often experience significant pain relief and improved stability, enhancing their ability to perform daily activities.