If you suffer from arthritis or other sources of pain in your back, shoulder, knee or hips, your surgeon may well suggest joint fusion surgery as an effective solution. In this common procedure, surgeons will physically fuse the two parts of affected joints, easing the pain caused by friction. This can deliver huge benefits in some but not all cases.
Our joints play a key role in human mobility. From the vertebrae in our spines to our ankles, knees, thumbs, hips and shoulders, they are essential parts of our skeletal system. However, they can also decay or suffer the effects of pathologies like arthritis - causing severe pain and a dramatic lowering in a person's quality of life. Joint fusion surgery is one solution to joint pain. Also known as arthrodesis, these procedures fuse together the components in joints, theoretically removing the friction which can cause chronic pain. Instead of bone rubbing against bone, fused joints present a solid mass, which can also result in more stable joints. So there are multiple potential benefits.
Before we outline a typical arthrodesis procedure, it's important to know that joint fusion varies considerably from patient to patient. Different joints require different treatments and may have different success rates as well. Your surgeon will discuss these details well before you sign up for any hospital appointments.
Before you are approved for joint fusion surgery, you will need to receive a clear diagnosis from a qualified physician. This will assess the degree of arthritis and physical decay within the affected joint and take into account whether you are able to undergo surgery to resolve the issue. At this stage, options will be discussed, including alternative therapies based on pharmaceuticals or physiotherapy or other forms of surgery such as annuloplasty (for lower back pain). The aim is to find the right treatment for each individual. When that has been agreed, a surgery date can be set and you will be issued with recommendations about diet and lifestyle as the surgery date approaches. If you need help find the right specialist, Qunomedical is here to help you. Contact us anytime.
Expect to be admitted to hospital for an overnight stay - possibly slightly longer. When you enter the theatre, your surgeon will most likely administer a general anaesthetic to ensure that no pain is experienced during the procedure.
When the anaesthetic has taken effect, the surgeon will make an incision around the joint, allowing them to gain clear access to the area being fused. They will then clear away any damaged cartilage tissue and fuse the caps of the bones being joined together. If there is a mismatch between the two parts of the joint, it may also be necessary to graft extra bone fragments onto the joint, filling in the gap and ensuring a tight fit. This bone will usually be taken from the hip, knee or heel and will not impair the functioning of those body parts. In some cases, synthetic implants can be used to achieve the same result. This is especially common in sacroiliac joint fusion (also known as SI fusion), which joins bones in the lower back and pelvis. Implants tend to be made from inert materials like titanium.
If implants are used, surgeons will need to take care to ensure that they are positioned in exactly the right place to bond together joints effectively. To do so, they may well employ an imaging technique called fluoroscopy, which lets them see inside the joint.
When your surgeon is happy with the state of the joint, the next stage is to physically fuse the joints. This is achieved via a series of screws, wires or plates which exert force on the joint, fusing bones together over time. Done properly, the whole procedure is comparably quick and non-invasive. That's especially the case with advanced medical implants - although, as noted above, some joints may require more complex, invasive procedures.
Finally, any incisions need to be closed and dressed. You will then be provided with information about wound care, how to promote bone fusion, and when to begin stepping up your activity levels. It is generally possible to return home within one to two days.
The main variations in arthrodesis surgery revolve around which part of the body is being treated. Some procedures have fallen out of fashion in recent years (such as hip and knee fusions), but ankle and SI fusion procedures are still a popular option.
Versions you may encounter include: sacroiliac joint fusion (lower back and pelvis), subtalar fusion (ankles) and glenohumeral fusion (shoulders). However, arthrodesis can be prescribed for anything from little fingers to thumbs as well. In terms of spinal fusion surgeries, these procedures can be defined as "anterior" or "posterior." In posterior fusion, bone fragments or synthetic implants are placed beneath the lumbar vertebra. This variant has the strongest record when it comes to pain relief, but can be more invasive, requiring an approach through the abdomen. The other option is to approach the spine from behind (hence the name "posterior"). More common than the anterior approach, posterior joint fusion tends to be less invasive
When undergoing joint fusion treatments, there is an excellent chance that your pain will subside, providing an enhanced quality of life in the medium to long term. However, pain relief is not automatic, and some patients fail to see noticeable results. In that case, you may need follow up surgery, or additional treatment options may be suggested. If all goes well, expect a hassle-free hospital admission followed by a lengthy period of recovery. The first couple of weeks may require long periods of immobility and self-discipline. Even though you feel capable of increasing the load on your joint, you will need to exercise restraint until the fusion has become strong enough. Within 12-14 weeks, many patients are back to normal, and their joints are pain-free. In some cases, mobility will be dramatically increased. However, remember that other joints will need to compensate for the fused joint and it may be necessary to stick closely to physiotherapy plans to ensure the best results.