Treatment Guides

Joint Fusion Surgery

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.

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quick details
  • Individuals who suffer from forms of arthritis. Less commonly prescribed for older patients, who may benefit from joint replacements.
  • Athletes with certain musculoskeletal injuries, allowing them to play sport without pain.
  • Women who have experienced serious back pain resulting from pregnancy complications.
  • To correct posture issues in some individuals, particularly relating to curvature of the spine.
  • Individuals with no history of problems with wound healing, and no underlying conditions which compromise their bone structure.
  • Expect the joint to heal within 12-14 weeks, although full mobility may not be restored for six months.
  • In some instances, joint mobility will be significantly impaired following fusion surgery, while pain is radically reduced.
  • Patients can usually return home within one to two days of surgery although in many cases, a short period of bed rest is often needed as patients recover.
  • Procedure durations vary depending on the complexity of the operation being carried out. In some cases, patients can leave hospital on the day of their operation. However, most cases will require a short hospital stay.
  • From start to finish, the treatment process can take as long as 6 months.
  • Success rates of between 80% and 90% have been reported by leading healthcare institutions.
  • Around one in 10 patients experience instability or a re-rupture.
  • Success is often gauged according to the patient's lifestyle. The success rates among professional athletes (whereby they can return to competition) are a little lower.
  • Joint fusion surgery carries a variety of risks, including pain and infection at the graft site, scarring, bleeding and potential nerve damage.
  • In some cases, the bone fusion is not successful, leading to a condition known as pseudoarthrosis, which requires additional grafting procedures.
  • If the spinal region is affected, there is an additional risk of spinal fluid leakage, which will also necessitate additional surgery.
  • Problems may develop with neighbouring joints, which are forced to work harder when a joint is taken out of action.
  • In extreme cases, severe loss of mobility has been known to occur. However, this is very rare owing to modern surgical techniques.

What is Joint Fusion Surgery?

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.

How Does Joint Fusion Surgery Work?

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.

1. Initial consultation and diagnosis

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.

2. Hospital admission and anaesthesia

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.

3. Incision and preparation

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.

4. Positioning implants and ensuring a perfect fit

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.

5. Securing 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.

6. Sutures and recovery

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.

Are There Different Types of Joint Fusion Surgery?

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

What Should I Expect?

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.

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