Arthrodesis (joint fusion) for arthritis

Arthrodesis is a type of surgery that fuses bones at a joint to relieve pain. It’s often used for people with severe arthritis, a condition that reduces cartilage in a joint. The lack of adequate cartilage in a joint causes bones to rub together, producing pain. Fusing the bones into one continuous bone structure eliminates any movement in the space between bones that may be causing pain.

Arthrodesis surgery is often used for joint fusion in the spine, ankle, feet, and wrists, though it can be used to fuse bones in other joints too. Penn Medicine Orthopaedics has specialists in back and neck pain, foot and ankle pain, and hand and wrist pain, among other areas of the body. They are experts in using arthrodesis to treat arthritis in specific areas. They’ll work with you to create a treatment plan to restore function and help you get back to living pain-free.

People with severe arthritis are among those who most commonly have arthrodesis treatment. If you have arthritis pain that has not responded to nonsurgical treatments, including medications, physical therapy, or bracing, you may be a candidate for arthrodesis, particularly if you experience these symptoms:

• Severe joint pain or stiffness that does not go away
• Limited mobility that impacts your daily life

It can be a personal choice to decide whether to proceed with joint fusion for arthritis. Your doctor will give you a physical exam, review your medical history, and discuss your symptoms to help determine if joint fusion is right for you.

Joint fusion surgery can vary widely depending on which joint is being fused. Talk with your doctor about whether you’ll have inpatient or outpatient surgery and how long the surgery will take. For example, joint fusion of the spine may take longer than joint fusion of the wrist.

In general, you can expect the following:

• You’ll have a pre-operative medical exam to be sure you are ready for surgery. This will likely include imaging tests and blood tests, among others. Your doctor will discuss any restrictions related to medications, food, and drink prior to surgery.
• On the day of the procedure, you’ll receive anesthesia to keep you pain-free during surgery. This may be a general anesthesia that puts you to sleep or a regional anesthesia near the site of the joint fusion.
• Your surgeon will make incisions in the skin to access the joint and remove any damaged tissue.
• They’ll attach the bones with some type of hardware, which may include plates, screws, or pins. Bone grafting may be done to help the bones heal together.
• Once the bones have been fused and fastened, the incision will be closed.

Recovery from arthrodesis often depends on where in the body your joint fusion is performed. Full recovery may take a few months or up to a year. Talk with your surgeon about specific recovery timelines for your type of surgery.

There are some typical experiences that most people have after arthrodesis surgery:

• It’s common to feel pain near the surgery site for the first few weeks after surgery. Your doctor will create a pain management plan for you, including prescription medications or over-the-counter drugs. Over time, you’ll be able to decrease your medication usage.
• You may need assistive devices, such as splints or crutches, as you heal.
• Your orthopaedic team will create a physical therapy plan for you, which you’ll start as soon as your progress dictates.
• Working with your doctor and physical therapy team, you’ll have a step-by-step plan to return to your regular daily activities.

While recovery from arthrodesis may take some time, most people have successful outcomes. After surgery, your joint may have more limited mobility than before, but you should have less pain and increased function that allows you to get back to your daily activities with confidence.

An arthrodesis procedure is considered a safe surgery and is often highly successful. Though, as with any surgery, there are some risks. Complications can vary based on your health history, age, and type of surgery. They include:

• Infection
• Bleeding
• Failure of the bones to fuse properly (nonunion)
• Hardware failure
• Pain that does not resolve
• Limited mobility in the joint

Talk to your doctor if you have questions about possible risks and any steps you can take before surgery to help ensure the most successful outcome.

Our orthopaedic team completes thousands of procedures a year, including arthrodesis surgeries. We take an integrated approach to understanding your specific case and work with you to create the optimal treatment plan to treat your arthritis pain.

When you come to Penn Medicine for arthrodesis surgery, you can expect:

• A collaborative approach: Our doctors, nurses, and physical therapists take a whole-body approach to diagnosing and treating your arthritis pain. We consider your overall health, lifestyle, and personal goals in creating a treatment plan that will get you back to performing your regular activities without pain.
• Minimally invasive surgeries: We offer the latest technologies and advances in minimally invasive surgeries and use them whenever possible to help speed recovery times and heal with fewer complications.
• A second opinion, if needed: You may want to be sure you’ve considered all of your options before proceeding with arthrodesis surgery. We offer second opinions to provide peace of mind in determining the best path for you.
• Convenient locations: When you’re experiencing pain, it’s helpful to have expert care close to home. We offer orthopaedic care throughout the southeastern Pennsylvania and New Jersey regions to make it easier for you to access the care you need.