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Arthrodesis surgery is a common procedure used to treat chronic, severe arthritis. It is most commonly performed on damaged wrist and ankle joints, but arthrodesis surgery may also be performed to correct spine, finger, or hip problems. During the procedure, a surgeon manually straightens out the affected joint, removes damaged bone and cartilage tissue, and fuses bones together with surgical screws and grafted tissue. Most patients who undergo the surgery and engage in follow-up physical therapy are able to recover from painful arthritis symptoms and maintain strength in their joints.
Before considering arthrodesis surgery, doctors usually exhaust nonsurgical arthritis treatment options. If anti-inflammatory drugs, corticosteroids, and specialized exercise routines do not help a patient find relief, his or her doctor can suggest a consultation with an orthopedic surgeon. The specialist can study x-rays and other imaging scans to determine what type of surgery would be most appropriate for a patient's specific condition. This surgery is usually preferred for smaller joints, such as those in the wrist and feet, while a procedure called arthroplasty is considered for larger, more complex structures in the knees, shoulders, and hips.
Arthrodesis surgery on a finger, toe, wrist, or ankle is usually conducted in an inpatient hospital and normally requires a stay of one to two days. Spinal arthrodesis typically requires a hospital stay of at least a week due to the risk of possible complications. The procedure itself generally takes less than three hours, during which time a patient may be placed under general anesthesia or given a localized anesthetic.
During arthrodesis surgery, the orthopedic surgeon makes a long incision along the base of the joint and pulls aside fat, cartilage, and muscle tissue. If the joint is out of alignment, he or she forces it back into place and cuts away sections of impeding bone and cartilage. Small gaps between the bones that make up the joint are usually filled with grafted tissue from another bone in the patient's body or from a donor. Larger joints typically require the insertion of pins or screws to secure the bones together. The surgical scar is then sutured and dressed in a protective bandage.
Following the procedure, a patient is typically monitored in a recovery room and fitted with a protective boot, brace, or splint. Doctors usually advise patients to avoid bearing weight or pressure on their joints for about six weeks, at which time they can return for a checkup. When healing is progressing as expected, an individual can engage in light stretching and strengthening exercises as part of a rehabilitation program for up to two years. It is usually not possible to regain full functioning of a joint due to the permanent bone fusion, but exercises can help maintain some degree of flexibility and versatility.