Joint Arthrodesis

Joint arthrodesis is a procedure that fuses two bones of a joint together in order to relieve pain. It is also called joint fusion. It is used to treat mainly to treat arthritis. This procedure gets rid of the joint by fusing it. A joint is where two or more bones come together, like the knee, hip, elbow or shoulder. Joints can be damaged by many types of injuries or diseases, such as arthritis. All types of arthritis involve destruction of the joints. This can cause pain, stiffness and swelling.

Introduction

Joint arthrodesis is the fusing together of two bones in a joint. For this reason, joint arthrodesis is also called joint fusion. Joint arthrodesis is often used to treat arthritis in certain joints. All types of arthritis involve inflammation and some destruction of the joints, which typically causes pain as well as deformity of the joint. This program will help you understand the benefits and risks of joint arthrodesis.

Anatomy

Our bones help us stand up straight and our muscles help our bones to move together. Bones connect at the joints. The most obvious joints are the shoulders, elbows, wrists, hips, vertebrae, knees and ankles. We have joints between the different bones of our fingers and toes. We also have joints that allow our vertebrae to move. A material called cartilage covers the ends of the bones of a joint. It allows the bones to move smoothly making for painless joint movements. There is a little bag containing a small amount of fluid called synovium between the two pieces of cartilage in a joint. The combination of cartilage and synovium allows for smooth, painless motion in any given joint.

Symptoms and Their Causes

Arthritis is the main reason for joint arthrodesis. Arthritis happens when the cartilage and the synovium in joints are destroyed. There are many types of arthritis. Osteoarthritis is due to chronic wear and tear. Osteoarthritis is more common in older people. Post-traumatic arthritis is due to trauma to a joint. Trauma may happen, for example, during a car accident or sports injury. All types of arthritis involve inflammation and some destruction of the joints. Arthritis usually leads to pain and limited movement in the joint. It also causes deformities in joints. Rheumatoid arthritis involves swelling, redness, and tenderness in the joint. If the synovium in a joint becomes inflamed, it could end up being destroyed along with the underlying joint. Rheumatoid arthritis causes this kind of destruction.

Alternative Treatments

Unfortunately, there is no cure for most types of arthritis. Arthritis can be slowed and controlled with various medications that decrease inflammation in the body. Some medications used to fight arthritis are common, over-the-counter drugs. Examples include ibuprofen and naproxen. Stronger medications can be used to treat arthritis. These include various types of steroids. Steroids are very helpful medications but they have numerous possible side effects. Steroids should be taken as prescribed and should never be stopped without talking to a healthcare provider first. Sometimes medications used to treat cancer can reduce inflammation caused by rheumatoid arthritis. Physical therapy may be used to keep joints affected by arthritis in shape. Splints are commonly used to prevent, slow down, or make up for joint deformities. If other treatments are unsuccessful, surgery may stop joint deformity and increase the use of a joint. Sometimes surgery can take pressure off the spinal cord or nerves in the spine. Two types of surgeries may be used to treat arthritis: joint replacement and joint arthrodesis. Joint replacement removes the damaged joint and puts in a new one. The goal of joint arthrodesis is to fuse two bones of a joint together in order to relieve pain. This eliminates the joint. Without the joint, you will no longer have the movement that the joint allowed. However, fusing the two bones together allows for stability and pain relief. The fused area can also still bear weight.

Surgical Treatment

Joint arthrodesis aims to relieve pain and arthritis symptoms by fusing together the two bones of a joint. The operation is done through a skin incision. It may be done as either an open or arthroscopic surgery. An open surgery involves a larger incision than an arthroscopic surgery. An arthroscopic surgery uses instruments inserted through smaller incisions. During the operation, damaged cartilage is removed first. Next, the bones are fused together. This may be done in different ways. A bone graft may be used in some surgeries. A bone graft is taken from another part of the body. It may also be taken from a donor. The bone graft is then placed between the two bones in a joint. Eventually the bone graft causes the two bones to grow, or fuse, together. Another way joint arthrodesis may be done is by using implants. These implants may include metal plates, wires, or screws. Sometimes a bone graft may be used with implants to fuse two bones together. At the end of the operation, the skin incisions are closed.

Risks and Complications

This operation is very safe. There are, however, several possible risks and complications which are very unlikely but possible. You need to know about risks and complications just in case they happen. By being informed you may be able to help your doctor detect complications early. The risks and complications include those related to anesthesia and those related to any type of surgery. Risks of general anesthesia include nausea, vomiting, urinary retention, cut lips, chipped teeth, sore throat, and headache. More serious risks of general anesthesia include heart attacks, strokes, and pneumonia. Your anesthesiologist will discuss these risks with you and ask if you are allergic to certain medications. Blood clots in the legs can occur due to inactivity during and after the surgery. These usually show up a few days after surgery. They cause the leg to swell and hurt. Blood clots can become dislodged from the leg and go to the lungs where they will cause shortness of breath, chest pain and possibly death. It is extremely important to let your doctors know about any symptoms that occur. Sometimes the shortness of breath can happen without warning. Getting out of bed shortly after surgery may help decrease the risks of blood clots. Some of the risks are seen in any type of surgery. These include the following:

1. Infection, deep or at the skin level

2. Bleeding, either during or after the operation

3. Skin scars that may be painful or ugly

Other risks and complications are related specifically to this surgery. These again are very rare. However, it is important to know about them. Nerves in the area the surgery was performed may be injured during joint arthrodesis. This may cause pain, weakness, or loss of feeling. Rarely, joint arthrodesis is not successful. The bones may not fuse together over time as they should. The metal implants may also break. Arthritis may also develop in joints near the one that was fused. This is because extra stress is placed on these joints after the fusion. Sometimes the pain may not be relieved by the operation. It may even be worse than before the operation. However, this rarely happens. Other possible risks of joint arthrodesis are slow healing of the incision and a delay in when you can return to your normal activities.

After the Surgery

The length of time you spend in the hospital depends on which joint was fused. Some patients may go home the same day as the operation. After the operation, the fused joint may be in a cast or brace. If you had your ankle fused, you won’t be able to put weight on it until the bones have fused. This may take 8 to 12 weeks. Sometimes inserts or special shoes may be worn after an ankle fusion. This helps with walking since the movement in the ankle joint is eliminated.

Summary

Joint arthrodesis is the fusing together of two bones in a joint. For this reason, joint arthrodesis is also called joint fusion. When appropriate, joint arthrodesis may be used to treat arthritis in certain joints. All types of arthritis involve destruction of the joints, which typically causes pain as well as deformity of the joint. Joint arthrodesis is very successful in helping to decrease your pain and to improve the quality of your life.