Arthrodesis is also known as artificial ankylosis or syndesis. It is an operation designed to produce bony ankylosis of a diseased joint often done in joints or bones near the joint affected by infection, tumors, trauma, and paralytic conditions.
It is also used in certain cases of painful osteoarthritis and rheumatoid arthritis as a pain relieving measure.
It is important to understand the difference between ankylosis and arthrodesis. Ankylosis refers to a stiff joint irrespective of the cause for stiffness. Arthrodesis always means that the joint has been fused surgically.
The main disadvantage of arthrodesis is that it sacrifices the movement of joint. Thus the function of the limb is definitely compromised. For example, in the lower limb, energy requirements for ambulation are increased.
Therefore the arthrodesis is contemplated only in patients in which the advantages outweigh the disadvantages.
Arthrodesis is most commonly performed on joints in the spine, hand, ankle, and foot.
Earlier, knee and hip arthrodeses were also performed in great numbers but with the great successes achieved in hip and knee arthroplasty, arthrodesis of these large joints has reduced in number.
However they are still used as procedures of last-resort in some failed arthroplasties.
Arthrodesis can be of following types
- Combined intraarticular and extraarticular.
In intraarticular technique the joint surfaces are bared and fused.
In extraarticular arthrodesis, the joints are not exposed and the arthrodesis is achieved by producing fusing bone block outside the joint. Extraarticular techniques are especially useful in treating children, because much of children’s joint surfaces are cartilage, and in treating patients who have large amounts of necrotic bone or active infection, as in tuberculosis.
Intraarticular techniques permit greater correction of deformity and are satisfactory if adequate areas of healthy bone surfaces can be apposed.
How Arthro0desis is Achieved?
The basic idea is to ionduce the fusion the joint in desirable position and hold the bones in desirable position till the fusion is strong enough to hold without internal or external implant.
Arthrodesis is achieved by putting bone graft to induce the process of fusion with bone graft while position of the bones is held securely by internal or external fixation.
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