Arthrodesis (Joint Fusion)

What is arthrodesis?

Arthrodesis is a surgery that permanently joins two bones in a joint together. Healthcare providers also call it joint fusion.

Joints are any place in your body two bones meet. They help you move almost every part of your body.

A healthcare provider might suggest joint fusion if other, nonsurgical treatments haven’t helped you manage severe symptoms like joint pain, stiffness or trouble moving.

Types of joint fusions

Surgeons can perform joint fusions on lots of joints in your body, including your:

• Ankles.
• Feet.
• Spine.
• Sacroiliac joints.
• Wrists.
• Fingers and thumbs.

What does arthrodesis treat?

Severe arthritis is the most common reason people need joint fusions. If arthritis has worn away the cartilage that cushions and lubricates a joint, the bones will rub against each other. Over time, this can damage your joint and become extremely painful. Other reasons you might need a joint fusion include:

• Severe bone fractures (broken bones) that damage the bones in a joint.
• Specific health conditions that affect your joints (like a herniated disk or spondylolisthesis).
• If a damaged joint is hurting your ligaments, tendons or nerves.

What happens before arthrodesis?

You’ll meet with your provider and surgeon before an arthrodesis. They’ll ask about your symptoms and how much they affect your daily routine and quality of life. They’ll review which nonsurgical treatments you’ve tried and ask how well they’ve worked.

Be honest with your providers. It can be scary to find out you might need surgery, but don’t shortchange your experiences. If pain or other symptoms make day-to-day activities hard, it’s worth mentioning and you might be a good candidate for a joint fusion.

The preparation for specific types of joint fusions can be different, but in general, you’ll need:

• A physical exam to make sure you’re healthy enough for surgery.
• Blood tests.
• Imaging tests, including an X-ray. You might also need magnetic resonance imaging (MRI) or a computed tomography (CT) scan.

Tell your provider and surgeon all the medications and over-the-counter (OTC) or herbal supplements you take. You may have to stop taking some medications or supplements before your surgery.

Your surgeon will tell you when you should stop eating and drinking the day before your surgery. Most people need to avoid eating and drinking for 12 hours before arthrodesis.

What happens during a joint fusion?

On the day of your surgery, you’ll receive anesthesia to numb your body and make sure you don’t feel any pain. An anesthesiologist will give you either general anesthesia to put you to sleep and/or a regional anesthesia to numb the area around the joint that needs arthrodesis.

The exact steps for a joint fusion depend on which joint needs to be fused. Your surgeon will tell you what to expect. In general, they’ll:

• Make incisions (cuts) in the skin around your joint.
• Remove damaged cartilage and bone.
• Insert pins, wires, plates, rods or screws into the two bones that need to be fused.
• Secure the fasteners in place, then close the incisions.

As you heal, the two bones will grow together and become one. This makes previously damaged joints stronger, more stable and less painful.

How long does arthrodesis take?

How long a joint fusion surgery takes depends on where you need arthrodesis. Spinal fusions can take up to five hours. Smaller, less complex joints usually take less time. Your surgeon will tell you what to expect.

What happens after arthrodesis?

Some types of arthrodesis are outpatient procedures, which means you can go home the same day. Others are inpatient, and you’ll need to stay at least one night in the hospital so your care team can monitor you after surgery.

What are the advantages of arthrodesis?

The biggest benefit of arthrodesis is how much it can improve your quality of life. People who’ve had joint fusions usually experience significantly reduced or no pain and other symptoms once they recover. It’s a safe, effective way to relieve symptoms that other treatments couldn’t manage.

Joint fusion usually gives people permanent, lifelong symptom relief. Most people can return to all their routine physical activities, including exercise or playing sports.

What are the risks of arthrodesis?

Like any surgery, arthrodesis has some risks, including:

• Infections.
• Bleeding.
• Pain.
• Reactions to anesthesia.
• Nonunion (the bones don’t fuse correctly).

Having a joint fusion can permanently reduce the range of motion in a joint (how far you can move it). Because two bones have been joined to become one, you might not be able to move as much or as smoothly in that part of your body after surgery.

Some people need additional surgeries (revisions) in the future.

Talk to your surgeon about your risk of complications. They’ll help you understand any potential risks and decide if joint fusion is the best treatment option.

What is the recovery time for arthrodesis?

Arthrodesis recovery time varies depending on where you need it. Joint fusion in a finger usually heals faster than a spinal fusion, for example.

Recovery time after a joint fusion varies depending on where you need it. It can take anywhere from a few months to more than a year. Your surgeon will give you a specific recovery timeframe based on where you had arthrodesis and your unique situation.

You should be able to gradually resume your usual activities in the weeks after arthrodesis. Your surgeon or healthcare provider will tell you when it’s safe to resume physical activities. They’ll tell you which activities, movements or positions to avoid while you recover.

Is arthrodesis surgery painful?

You won’t feel any pain during an arthrodesis because of the anesthesia.

After surgery, you’ll feel pain, especially in the first few weeks of your recovery. You’ll feel pain from the surgery itself and pain as your body begins to heal.

Your surgeon will suggest a combination of prescription pain medication, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) (if it’s safe for you to take them) and acetaminophen to relieve your pain. Your surgeon will tell you how much of each kind of medication you can take every day or in a certain amount of time.

When should I call my healthcare provider?

Call your surgeon or healthcare provider right away if you experience any of the following symptoms:

• Fever higher than 101 degrees Fahrenheit (39 degrees Celsius).
• Bleeding.
• Signs of infection at your surgery site, including leaking, swelling, discoloration, odor or a feeling of warmth.
• New or worsening pain.

Is arthrodesis a major surgery?

Surgeons consider most types of arthrodesis major surgery, but that’s just a term they use to classify how complex a procedure is. What matters most is getting the right treatment to manage your symptoms and improve your quality of life. Talk to your healthcare provider or surgeon if you’re nervous before your joint fusion.

What is the difference between joint fusion and arthrodesis?

There’s no difference — they’re different terms for the same surgical procedure. Arthrodesis is the medical definition of joint fusion. Your provider or surgeon may use them interchangeably when talking about managing your symptoms with this type of surgery.

A note from Cleveland Clinic

Arthrodesis (joint fusion) is a surgical procedure to manage severe joint pain, stiffness and other symptoms that affect your quality of life. Your provider will usually only suggest it after other, nonsurgical treatments don’t work well enough to let you live the way you want.

It can take a while to recover after a joint fusion, but it’s worth it. Most people who have an arthrodesis feel a permanent reduction in pain and can get back to all their usual physical activities. Talk to your provider or surgeon before choosing arthrodesis. They’ll help you understand the benefits and risks and will help you choose the right option at the right time.