How Arthrodesis (Joint Fusion) Can Treat Advanced Arthritis

An arthrodesis is a surgical procedure, also called a joint fusion. In performing an arthrodesis, the goal is to permanently hold a joint in a fixed position, and allow the bone to grow across that joint. While this means the joint will never bend again, there is often dramatic pain relief in that area.

An arthrodesis procedure is sometimes performed for the treatment of advanced arthritis. Depending on the joint involved, arthrodesis can be an alternative to a joint replacement surgery and may be recommended in certain individuals who are likely to have problems with joint replacements. In some cases, arthrodesis is recommended to younger, more active individuals who are likely to have problems wearing out a joint replacement.

Prior to the advent of joint replacements, arthrodesis was the standard surgical procedure performed for most all types of arthritis. In the past decades, many types of joint replacement have improved dramatically. In particular, hip replacement and knee replacement surgery are becoming more common. Therefore, hip fusion and knee fusion are becoming very infrequently performed.

Other joints are still commonly fused. For example, in the case of ankle arthritis surgery, there is a big controversy between ankle replacement and ankle fusion, and which procedure is better. Some surgeons advocate for one over the other, and for some patients, one procedure may be better than the other.

For a few joints in the body, fusion is a better surgical option. For example, some of the small joints of the hand and foot where there are no options for replacement, a fusion may be the preferred surgical treatment option.

Complications of an arthrodesis include increased wear on neighboring joints (since the joints above and below the fusion have to do more work) and nonunion of the fusion. A nonunion occurs when the bone does not grow across the fused joint, which will eventually cause problems. Often metal plates and screws are used to help fuse a joint, but bone has to grow across for this to be a permanent fix. Nonunions are especially common in smokers, causing some surgeons to avoid even attempting a fusion if someone is a smoker. In addition, patients undergoing arthrodesis need to understand the affected joint will no longer bend.