Joint Fusion

What is a joint fusion?

Joint fusion is a procedure in which your healthcare provider makes the bones of your joint grow together solidly so the joint will no longer bend.

When is it used?

Reasons for doing this procedure are:

• The joint may be unstable.
• The joint may have been damaged by disease and is very painful whenever you move it.

Alternatives to this procedure are:

• wearing a brace
• having the joint replaced with an artificial one
• choosing not to have treatment while recognizing the risks of your condition.

You should ask your healthcare provider about these choices.

How do I prepare for a joint fusion?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before the procedure.

Follow the instructions your provider gives you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given a regional or general anesthetic, depending on which joint is being fused. A regional anesthetic numbs part of your body while you remain awake. A general anesthetic relaxes your muscles and puts you to sleep. Both kinds of anesthesia will prevent you from feeling pain during the operation.

Your healthcare provider makes a cut in the skin over the joint. He or she will then expose the joint by moving muscles or ligaments. Your provider will roughen the bones of the joint and lay pieces of bone (either donor bone or some pieces of bone removed from your hip) over the joint. While it heals, the fused joint will be held in place with one or more of the following: cast, pins, screws, or plates.

What happens after the procedure?

You may be in the hospital for 1 to 4 days. You will not be able to bend the joint. You may have to wear a brace or cast after surgery. Ask your healthcare provider what steps you should take and when you should come back for a checkup after you are out of the hospital.

To learn how to move your arm or leg without bending the joint, you will work with a physical or occupational therapist (or both).

What are the benefits of this procedure?

Your joint may stop being painful.

What are the risks of this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Regional anesthesia is considered safer than general anesthesia.
• You may have infection or bleeding.
• You may have nerve or artery damage.
• The bones may not fuse and you will need further surgery.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You have a fever.
• You have a lot of pain.
• You have unusual warmth, redness, or swelling.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.