Knee arthrodesis is a procedure that fuses the thigh bone to the lower leg bone at the knee. The joined bones may be secured with plates and screws. This method of support is called internal fixation. It provides support while the bones fuse together.
The knee will no longer be able to bend after this surgery.
Knee arthrodesis may only be done if all other repair methods are not appropriate or have failed. It may be done: After a failed knee replacementIn patients with chronic joint infections that have led to severe knee damageIn patients with debilitating pain that cannot be resolved by other treatment options
Joint Damage Due to Arthritis
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Arthrodesis may reduce pain and improve overall function. However, it will prevent bending at the knee and will cause a limp.
Your doctor will review a list of possible complications, which may include: Excess bleedingAdverse reaction to anesthesia InfectionBlood clotsLoosening of components in patients with poor bone qualityThe thigh and shin bones do not join together as expected
Factors that may increase the risk of problems include: SmokingSome chronic diseases, like obesity or diabetesHeavy alcohol use
Make sure you talk to your doctor about these risks before your procedure.
Your doctor may do the following before your procedure: Physical examBlood testsImaging tests, like x-rays or scansElectrocardiogram for heart functionHave you donate blood in case you need a transfusionPrescribe antibiotics to prevent infection
Before surgery, you will need to: Arrange for a ride home.Arrange for help at home while you recover.Talk to your doctor about any medications, herbs, or supplements you are taking.Talk to your doctor about any allergies you have.Ask your doctor about devices you will need after the surgery like a wheelchair, walker, or cane.
You may need to stop taking some medications up to 1 week before the procedure.
Do not eat or drink anything after midnight the day before your surgery, unless told otherwise by your doctor.
An incision will be made over the knee. A small amount of bone from the ends of the thigh bone and top of the lower leg bone will be removed. Other knee joint structures like cartilage and ligaments or knee replacements will be removed. The ends of the bones will be joined together, usually with a bone graft. Metal plates will be screwed into the joined bones.
The incision will be closed. A bandage may be placed over the incision.
Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.
The usual length of stay is about 3-4 days. It is possible that you may have to stay longer if complications arise. You may also go to a rehabilitation hospital to help you recover.
Right after the procedure, you may be given medication such as: Pain medicationAntibiotics to prevent infectionMedication that prevents blood clots
Physical therapy often starts within 24 hours after your surgery. During this time you may need devices to help you walk.
You will be able to leave when you are able to get around and do basic daily care activities on your own.
When you return home, take these steps: Follow your doctor’s instructions on sitting, bending, or sleeping positions.Continue with your physical therapist’s exercise program.Follow your doctor’s instructions.
Call your doctor if any of these occur: Signs of infection such as fever or chillsProblems at the incision site such as redness, swelling, pain, bleeding, or drainingNausea or vomitingPain that does not go away with the pain medication you have been givenNumbness or tingling in the lower legChest pain or trouble breathing
If you have an emergency, call for emergency medical services right away.
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http://orthoinfo.aaos.org/topic.cfm?topic=A00510. Updated September 2007. Accessed March 4, 2015.
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http://boneandspine.com/knee-arthrodesis. Accessed March 4, 2015.
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http://www.kneeguru.co.uk/KNEEnotes/node/1844. Updated September 2, 2008. Accessed March 4, 2015.
Knee Fusion for Irretrievably Failed Total Knee Replacement. About Joints website. Available at:
http://aboutjoints.com/physicianinfo/topics/fusionknee/kneefusion.htm. Accessed March 4, 2015.
Surgical site infection. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated December 15, 2014. Accessed March 4, 2015.
Talmo CT, Bono JV, et al. Intramedullary Arthrodesis of the Knee in the Treatment of Sepsis after TKR.
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Last reviewed March 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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