Arthrodesis - Orthopedic Surgical Procedure

 

Arthrodesis is an orthopedic surgical procedure in which a joint is surgically fused together. An arthrodesis procedure is performed on patients that have a joint deformity that prevents normal movement of structures above and below the joint.

Arthrodesis surgery can be performed in many ways, in many joints, and using many different techniques. The bones may be shaved to expose the growing surfaces of bone and enhance natural fusion. Sometimes a bone graft may be used to bridge an area between bones. In a bone autograft, a piece of bone is taken from somewhere else in the body and moved to the arthrodesis site. New bone grows around the grafted bone and, quite helpfully, bone taken from the same person is not rejected by the immune system like cadaver or donor bone would. If an autograft is not possible, an allograft is used (cadaver or donor bone tissue).

Recently there have been developments in synthetic bone substances. These materials, like hydroxyapatite (used in cosmetic surgery procedures), are placed around the arthrodesis site. Currently available synthetic bone materials do not provide strength or adhesion of bones. These arthrodesis tools are used to promote growth of new bone.

Arthrodesis may simply be performed using traditional orthopedic techniques. These include pins and metal ties. The bones placed close together will tend to grow and fuse with one another over time. Until that occurs, the metal connections give the joint stability.

An arthrodesis can be used to correct joint fractures, that is, bones that have fractured near the joint. These types of fractures make movement exceptionally difficult and healing of fractures in this area may be slow. Joint fractures can lead to further damage if the joint is not stabilized which is why arthrodesis surgery is sometimes indicated for these fractures.

The term arthrodesis is often used to describe the surgical fusion of bones in the ankle joint. This so-called triple arthrodesis was first described in the 1920s as a procedure in which three bones of the ankle were shaved, pinned, or tied together. This triple arthrodesis imparts great stability to the ankle joint since several of the small bones of the foot are surgically fused into one large bone. The bones in these three joints subsequently grow together as one bone after arthrodesis recovery is complete.

This surgical approach has the advantage of superior ankle stabilization though it sacrifices joint mobility. It is, after all, the various small bones of the ankle that allow the foot to move in various angles and directions.

Arthrodesis can also describe surgery of the spine in which two or more vertebrae are fused together. One would typically have spinal arthrodesis if there is a possibility of the individual vertebra moving apart from one another. This typically occurs in back trauma or strain in which the tendons, ligaments, and muscles are stretched and do not hold the spinal column in place. Misaligned vertebra can lead to tremendous pain and nerve problems. Spinal arthrodesis can prevent the slippage of these vulnerable vertebrae.