What to Know About Arthrodesis (Joint Fusion Surgery)

Arthrodesis is a procedure that involves the surgical fusion of two joints. Because the procedure immobilizes the joints, doctors typically only recommend it for severe joint pain or damage.

Arthrodesis is a surgery that can treat severe joint pain, injuries, and other symptoms that significantly affect quality of life. Doctors typically recommend it if nonsurgical treatments like physical therapy haven’t helped with your symptoms.

Here’s what else to know about what the procedure involves, its benefits, and the postsurgical outlook.

What is it?

Arthrodesis involves cutting into the skin around the affected joint, removing damaged cartilage and bone, and using metal parts to connect the two bones.

After the surgeon closes the incision and the incision begins to heal, the bones will eventually fuse into one. Fusing the bones means the joint won’t be able to bend or flex.

Fusion can make injured, weak, or damaged joints stronger and more secure as well as reduce pain.

A surgeon may perform arthrodesis on joints including the:

• wrists
• ankles
• hands
• fingers
• feet
• toes
• spine

Uses

Arthrodesis can treat a variety of conditions. Some conditions your doctor may recommend the procedure for include:

• Severe arthritis: If you have osteoarthritis or rheumatoid arthritis , you may need arthrodesis. Since arthritis wears away the cartilage that cushions the joint, the bones can rub against each other and cause pain. A fusion can help correct the issue.
• Genetic or lifestyle-related irregularities: Join fusion can remedy conditions like clubfoot or severe bunions .
• Neuromuscular conditions: People with Parkinson’s disease may sometimes benefit from spinal fusion surgery to alleviate nerve pain resulting from issues with the lumbar spine.
• Autoimmune conditions: Conditions like systemic sclerosis can cause joint scarring, and arthrodesis can help repair damage.
• Broken bones or joint injuries: Arthrodesis can correct injuries to the wrist, ankles, or hands. Spinal injuries like herniated disks may also benefit from fusion surgery.

What to expect

The procedure typically involves :

• a healthcare professional giving you a local anesthetic to numb the area and make sure you feel no pain during the procedure
• the surgeon creating an incision to expose the affected joint
• the surgeon removing the damaged cartilage
• the surgeon implanting metal parts like rods, pins, or plates into the joints to connect them
• the surgeon stitching up the area

You’ll wear a cast or splint during healing. Over the course of the next few months, the bones will heal and fuse.

Arthroplasty vs. arthrodesis

Arthroplasty is another common procedure for treating joint issues. Whereas arthrodesis fuses two joints, arthroplasty replaces the damaged bone with artificial bone.

Other key differences include:

• Mobility: Arthrodesis eliminates the movement of a joint by fusing it. Arthroplasty maintains mobility in the joint.
• Durability: Fused arthrodesis joints are effectively permanent. Meanwhile, the artificial joints in arthroplasty may eventually wear down and require replacement.
• Application: Surgeons most often perform arthrodesis on smaller joints, like the wrists, while arthroplasty is the current preferred method for hips and knees. Doctors rarely recommend arthrodesis for the hips, but they do occasionally use it for them.

Risks and complications

Doctors often recommend the surgery for younger people who have greater odds of maintaining strength, stability, and use of the joint.

Since fusing two joints can naturally restrict movement, you should consider if the benefits outweigh the risks. For instance, wrist or finger joint fusion surgeries may affect activities like playing sports, playing musical instruments, and typing. Meanwhile, spinal fusion surgery may affect your posture.

In a 2023 paper on wrist arthrodesis, the researchers note that study participants were unable to produce active wrist extension or flexion, meaning their wrists couldn’t move up, down, or side to side. Their grip ability was also reduced.

However, the procedure still may be an option for older adults, who have lower bone quality and who may be less physically active. In a 2019 review of thumb arthrodesis, the researchers note that the procedure is equally effective at improving grip strength in older and younger individuals, though pinch strength only improved in the younger group.

Arthrodesis also comes with other risks, including:

• infection
• bleeding
• pain
• issues with the bones fusing

Recovery and outlook

Arthrodesis recovery time may be several months to over a year depending on the location of the procedure on your body. For instance, finger fusion will typically heal faster than spinal fusion.

A surgeon will explain how the procedure might affect your physical activities. For example, it will limit your wrist mobility. They’ll also recommend any physical therapy support that may help improve your daily use of the joint.

You should be able to gradually resume activities in the weeks to months following surgery.

In the same 2023 paper mentioned above, the researchers note that 75% of people who had wrist arthrodesis were satisfied with their procedure.

The bottom line

Arthrodesis, or joint fusion surgery, fuses two joints permanently.

The procedure can significantly reduce pain and restore damage, whether due to an injury or a condition like arthritis. Remember that it may affect joint mobility to some degree, though the benefits may still outweigh the risks in some cases.