Joint Fusion Surgery FAQ

Also known as arthrodesis, joint fusion is a surgical procedure for the treatment of severe arthritis pain. It involves fusing together the bones in your aching joint to create one solid bone. The fused bone is often more stable and results in decreased pain.

Here’s a look at who needs joint fusion surgery and what you should know about it.

 

Who Needs Joint Fusion Surgery?

If your arthritis is severe and traditional treatments have not been effective for you, you may require joint fusion surgery. This procedure can be used to treat conditions of the back like scoliosis or degenerative disk disease. Joint fusion surgery can also be performed in the:

• Spine
• Wrists
• Fingers
• Ankles
• Thumbs
• Feet

 

Because joint fusion surgery involves a long recovery period, your doctor may want to confirm in advance that you’re prepared to cope with the extended healing process. This procedure is not right for you if you have:

• An infection
• Narrowed arteries
• Poor bone quality
• A nervous system issue that may prevent proper healing

What to Expect During Surgery?

Depending on the type of joint fusion you need, your procedure can be performed either in the hospital or in an outpatient facility. Here’s what you can expect:

1. Anesthesia: Your doctor may choose general anesthesia (you sleep through the surgery) or local anesthesia (you stay awake, but numbed in the area) for the surgery.
2. Incision: Your doctor will make a cut in the skin then scrape away damaged tissue from inside the joint to allow the bones to fuse together.
3. Bone placement: In some cases, the surgeon will place a new piece of bone in between the two joint ends. This new piece of bone can be taken from another area on your body (the pelvis, heel or below the knee in most cases), or it can come from a bone bank provided by the hospital. This also may be a man-made substance rather than actual human bone.
4. Closing space: From here, the surgeon will use metal plates, screws or wires to close the area between the joint. This is usually meant to be a permanent insertion of hardware. The incision will then be closed with sutures or surgical staples.

What Does the Recovery Process Look Like? 

Recovery from joint fusion surgery will take some time, during which the ends of the joint grow together into a single bone — eventually, you won’t be able to move this area. But until then, you need to keep the area protected with a cast or brace and keep all your weight off the joint. Many people use walking assistance devices like crutches, a walker or even a wheelchair. 

Expect stiffness and losing some range of motion. Recovery can take up to 12 weeks, so you may want to have a family member or friend around to help you during this time. Physical therapy may help reduce pain, as might non-steroidal anti-inflammatory drugs. Talk to your doctor about which medicines you should and shouldn’t take. 

Are There Any Risks?

Joint fusion procedures are generally safe, with low risk of complications. A few minor risks that do exist, however, include:

• Broken hardware
• Arthritis in nearby joints
• Infection or bleeding
• Blood clots
• Painful scar tissue
• Nerve damage
• Pseudoarthrosis—a condition in smokers where not enough bone can form to allow the joint to fuse together properly

Your doctor or orthopedic specialist can help you determine when joint fusion surgery might be right for you. 

 

Dr. Carlson tends to be conservative with surgical treatment, and much of his training is in minimally-invasive procedures, such as arthroscopy. He believes everyone deserves a trial of a more conservative treatment before moving to more invasive treatments such as surgery. Dr. Carlson tries to spend time with patients to better understand their goals and work together to come up with a treatment plan based on those goals and their distinct medical history.

 

Sources:

“What is Joint Fusion Surgery?” WebMD. https://www.webmd.com/osteoarthritis/guide/joint-fusion-surgery#1