What is Arthrodesis? Procedure, Benefits, and Recovery

What Is Arthrodesis?

Arthrodesis is a surgical procedure that permanently fuses two or more bones in a joint to eliminate motion and improve stability. During the procedure, the surgeon removes damaged cartilage and diseased joint surfaces, then aligns the bones in a functional position so healthy bone can grow across the joint space, forming a single, solid structure that eliminates the main source of pain while preserving joint support.

The arthrodesis procedure creates the conditions for natural bone healing. Plates, screws, or pins hold the bones firmly in place while new bone tissue gradually bridges the fusion site over the next few months. As healing progresses, movement-related pain reduces, and improves stability — the main benefit patients experience after successful fusion.

Why Arthrodesis Is Done

Healthcare providers recommend arthrodesis when conservative arthritis treatment options have been exhausted. Several compelling reasons drive this surgical decision:

• Severe, unrelenting joint pain that medications, physiotherapy, and injections cannot adequately control
• Joint instability caused by damaged ligaments, tendons, or bone structures that compromise daily function
• Failed joint replacements where artificial components have worn out or become infected
• Congenital deformities or traumatic injuries that have permanently altered joint mechanics
• infection or tumors affecting joint structures that cannot be preserved through other means

Joints Commonly Treated With Arthrodesis

Certain joints respond particularly well to the arthrodesis procedure, especially where long-term stability and pain relief matter more than preserving full motion:

• Ankle joints – often maintain good walking ability after fusion with minimal functional loss
• Foot and toe joints – preserve weight-bearing capacity while eliminating painful motion
• Spine and sacroiliac joints – provide crucial stability for the back and pelvis
• Wrist, finger, and thumb joints – support grip strength and functional hand use
• Shoulder joints – occasionally fused when replacement isn’t suitable

According to the NCBI, wrist arthrodesis (wrist fusion) immobilizes the wrist by fusing the radius to the carpal bones for pain relief when advanced wrist arthritis, post-fracture damage, or severe ligament injuries persist despite other treatments. It may be total or partial—with partial techniques such as scapholunate fusion, four-corner fusion with scaphoid excision, scapho-trapezoid fusion, scaphocapitate fusion, and radiolunate fusion—aiming to reduce pain while preserving as much function as possible.

How Arthrodesis Works (Surgical Concept)

The arthrodesis procedure involves removing the damaged cartilage from the joint surfaces and positioning the bones in optimal alignment. The bones are then fixed together using screws, plates, rods, or pins. Over time, new bone grows across the joint space, permanently fusing the bones into one.

This fusion stops joint motion, which is the primary source of pain in advanced joint disease.

Types of Arthrodesis Procedures

Modern arthrodesis techniques offer several approaches tailored to specific needs:

• Bone graft-assisted fusion - uses your own bone, donor bone, or synthetic materials to promote healing
• Internal fixation arthrodesis - employs metal hardware to compress and stabilise bones during fusion
• Minimally invasive arthrodesis - utilizes smaller incisions and specialised instruments when appropriate
• Computer-guided arthrodesis - incorporates advanced imaging for precise bone positioning

Conditions That Require Arthrodesis

Several medical conditions may necessitate joint fusion when other treatments prove inadequate:

• Severe osteoarthritis - the most common indication, particularly in weight-bearing joints
• Rheumatoid arthritis - when inflammatory damage destroys joint structures
• Post-traumatic arthritis - developing after fractures or significant injuries
• Joint infections - when bacteria damage cartilage and bone beyond repair
• Congenital abnormalities - birth defects affecting joint development and function

Symptoms That Indicate the Need for Arthrodesis

Recognising when conservative arthritis treatment is no longer sufficient helps guide surgical decisions:

• Persistent, severe pain that interferes with sleep and daily activities
• Significant joint stiffness limiting your range of motion
• Joint instability causing the joint to "give way" during normal use
• Progressive deformity that affects function and appearance
• Inability to bear weight or perform essential movements

Preoperative Evaluation Before Arthrodesis

Thorough preparation ensures optimal surgical outcomes and identifies potential complications:

• Comprehensive medical history including allergies, current medications, and previous surgeries
• Physical examination assessing joint function, muscle strength, and overall health
• Imaging studies like X-rays, CT scans, or MRI to evaluate bone quality and joint damage
• Blood tests checking for infection, clotting disorders, and general health markers
• Anesthesia consultation to determine the safest approach for your specific needs

Arthrodesis Procedure (Step-by-Step)

Understanding the surgical process helps reduce anxiety and promotes better recovery:

1. Anesthesia administration – either general or regional anesthesia ensures comfort throughout surgery
2. Surgical site preparation - thorough cleaning and sterile draping prevent infection
3. Incision creation - carefully planned cuts provide optimal access to the joint
4. Cartilage and bone removal - all damaged tissue is completely removed to create healthy surfaces
5. Bone positioning - precise alignment ensures optimal function after fusion
6. Graft placement - bone grafts fill gaps and promote robust healing
7. Hardware insertion - plates, screws, or pins secure the bones in proper position
8. Wound closure - layers are carefully repaired and dressed to promote healing

Recovery After Arthrodesis

Post-surgical recovery requires patience and commitment to achieve the best possible outcomes:

• Initial hospital stay - usually several days for pain management and monitoring
• Pain control - medications help manage discomfort during the healing process
• Immobilisation - casts, braces, or splints protect the fusion site
• Gradual mobilisation - careful progression from non-weight-bearing to full activity
• Physiotherapy - strengthening exercises for surrounding muscles and joints

Healing Time for Arthrodesis

The arthrodesis procedure requires substantial healing time for complete bone fusion. Initial healing typically occurs within 6–8 weeks, when patients may begin limited weight-bearing activities. However, complete bone fusion takes 3–6 months for smaller joints and up to 12 months for larger joints, such as the spine.

Several factors influence healing time, including your age, overall health, smoking status, and bone quality. Younger patients with healthy bones generally heal faster than older individuals or those with medical conditions affecting bone health. Proper nutrition, adequate rest, and avoiding activities that stress the fusion site promote optimal healing.

Regular follow-up appointments include X-rays to monitor fusion progress. Your surgeon will guide activity progression based on these imaging studies and your clinical healing signs.

Post-Surgery Restrictions

Following post-operative guidelines is crucial for successful arthrodesis outcomes:

• Weight-bearing limitations - avoiding stress on the fusion site until healing is confirmed
• Activity restrictions - no high-impact sports or activities that could disrupt healing
• Driving limitations - restrictions vary by joint location and healing progress
• Work modifications - temporary adjustments may be needed for physical jobs
• Smoking cessation – tobacco use significantly impairs bone healing and increases the risk of complications

Possible Complications of Arthrodesis

While arthrodesis surgery has high success rates, potential complications require awareness:

• Non-union - failure of bones to fuse properly, potentially requiring additional surgery
• Infection - surgical site infections requiring antibiotic treatment
• Hardware problems - loosening, breakage, or irritation from metal implants
• Nerve damage - temporary or permanent numbness or weakness
• Blood clots - particularly in leg surgeries, requiring preventive measures

Arthrodesis Success Rate

The arthrodesis procedure demonstrates excellent success rates across different joints. Studies show that over 90% of patients experience significant pain relief following successful joint fusion. Ankle arthrodesis achieves fusion rates of 85-95%, while spinal fusions succeed in 80–95% of cases.

Success depends on multiple factors, including patient age, bone quality, smoking status, and adherence to post-operative instructions. Patients with healthy bones and good overall health typically achieve the best outcomes. Even when complete fusion takes longer than expected, most patients still experience substantial pain improvement.

Long-term satisfaction rates remain high, with most patients reporting they would choose arthrodesis again for similar circumstances.

How to Prevent Complications After Arthrodesis

Proactive measures significantly reduce complication risks and promote successful healing:

• Strict adherence to weight-bearing and activity restrictions
• Regular follow-up appointments for monitoring and early problem detection
• Proper nutrition, including adequate protein, calcium, and vitamin D for bone healing
• Smoking cessation - tobacco use dramatically increases non-union risk
• Infection prevention through proper wound care and hygiene
• Medication compliance, taking prescribed antibiotics and pain medications as directed

When to See a Doctor After Arthrodesis

Recognising warning signs helps prevent serious complications and ensures prompt treatment:

• Increasing pain, swelling, or redness at the surgical site
• Fever or chills suggesting possible infection
• Drainage or foul odour from the incision
• Numbness or tingling that worsens or doesn't improve
• Hardware loosening or movement you can feel or see

Conclusion

Arthrodesis can offer long-term pain relief and stability when a damaged joint no longer responds to medicines, therapy, or other procedures. With the right evaluation and post-surgery care, most patients can return to everyday activities with improved comfort—even though the fused joint will have reduced mobility.

For pre-op assessment and recovery monitoring, Metropolis Healthcare supports you with 4,000+ tests, full body checkups, and specialty testing, plus home sample collection with quick turnaround and accurate results through 10,000+ touchpoints. Booking is easy via the website, app, phone, or WhatsApp, allowing you to manage diagnostics conveniently without disrupting your routine.

FAQs

What is arthrodesis used for?

Arthrodesis is used to relieve severe joint pain, improve stability, and correct deformities when conservative treatments fail.

Is arthrodesis the same as joint replacement?

No. Arthrodesis permanently fuses the joint, while joint replacement preserves movement by replacing the joint surfaces with artificial components.

How long does arthrodesis take to heal?

Initial healing takes 8–16 weeks, but complete bone fusion may take several months.

Does arthrodesis reduce mobility?

Yes. Arthrodesis eliminates movement in the treated joint, but it often improves overall function by relieving pain.

Is arthrodesis a permanent procedure?

Yes. Arthrodesis permanently fuses the joint and cannot be reversed.

What are the risks of arthrodesis surgery?

• Infection
• Nonunion
• Hardware failure
• Blood clots
• Reduced range of motion

Can you walk after ankle arthrodesis?

Yes. Most patients can walk comfortably after healing, though ankle movement is limited.

Is arthrodesis painful?

Post-surgical pain is temporary and manageable. Long-term pain is usually significantly reduced.

What is nonunion in arthrodesis?

Nonunion occurs when the bones fail to fuse properly, sometimes requiring additional surgery.

Which joints are most suitable for arthrodesis?

Ankle, wrist, spine, and small joints of the hand and foot are most commonly treated with arthrodesis.