Osteoarthritis: Surgery for Joint Pain Relief

Joint Fusion (Arthrodesis) for Joint Pain Relief

Like osteotomy, this joint surgery may be done when joint replacement isn't an option. The osteoarthritis-involved bones are fused so they grow together to form one bone. Although the fused joint is not flexible, it's very stable. Arthrodesis is done to relieve pain in the spine and smaller joints -- such as the ankles, wrists, fingers, and thumbs.

Benefits and Risks of Joint Fusion Surgery

Benefits include:

• Osteoarthritis pain relief
• A straightened and stabilized joint

Risks include:

• Nerve or artery damage
• Lack of bone fusion, requiring more surgery

What Happens During Joint Fusion Surgery

The surgeon makes an incision over the joint affected by osteoarthritis, then exposes it by carefully moving aside muscles or ligaments. Next, the surgeon roughens the bones of the joint and lays pieces of donor bone or your own bone over the joint to start the fusion process.

During healing, the fused joint is kept in place with a cast, pins, screws, or plates. Depending on the joint fused, you may be hospitalized for one to four days and wear your joint support for a period of time after going home.

Joint Fusion Recovery: What to Expect

You'll need to adjust to moving and using the limb without bending it. This can make it harder to do some familiar things, like climbing stairs or getting into a small car, and some people walk differently after surgery.

Also, it's normal to have some pain, tenderness, and stiffness after surgery. Before you go home, ask about signs and symptoms of complications. At home, call your surgeon if you have any concerns.

Resection Arthroplasty for Joint Pain Relief

Resection arthroplasty is the removal of all or part of a joint to eliminate damaged surfaces from moving on each other. It's rarely done on a weight-bearing joint such as the knee or hip, because you need the joint to walk. But it may be done on a "hanging joint" such as the shoulder. For a good example of this procedure, let's look at resection arthroplasty of the shoulder:

Benefits and Risks of Resection Arthroplasty

Benefits include:

• Relieving shoulder pain and tenderness
• Allowing freer shoulder movement

Risks include:

• Possible damage to nerves and blood vessels in the surgical area
• Risk of infection

What Happens During Resection Arthroplasty

If you were having shoulder arthroplasty, your surgery could take place two possible ways:

• For open surgery, the surgeon typically makes a bone-cut through a 2-inch incision.
• An arthroscope may be used; this allows bone access through a smaller incision.

The orthopaedic surgeon removes the last half-inch of the shoulder blade (clavicle). This creates a space between the cut end and the scapula (the shoulder bone that meets the shoulder). The space is not filled. Over time, scar tissue grows into this space, letting the shoulder joint move but stopping bones from painfully rubbing together.

Resection Arthroplasty Recovery: What to Expect

It's normal to have some pain, tenderness, and stiffness after surgery. You may need to wear a shoulder-support sling for a few days and receive treatment with ice and electrical stimulation. You'll probably have physical therapy -- first to control pain and swelling in the area, later to ensure that the joint moves smoothly.

Before you go home, ask about signs and symptoms of complications. At home, call your surgeon if you have any concerns.

Is Joint Surgery Right for You Now?

Keep in mind that recovery from any surgery will take time, and the outcome depends a good deal on following your surgeon's instructions for exercise and further treatment. The effort you give at this important time can make a big difference in your enjoyment of the years to come.

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