Knee Arthrodesis with Internal Fixation
Definition
Knee arthrodesis is surgery to fuse the thigh bone to the lower leg bone at the knee. The knee will no longer be able to bend after this surgery.
Reasons for Procedure
This surgery is done to ease pain and improve function in people who have not been helped by other methods. It may also be done after a failed knee replacement or in people with damage from joint infections.
Joint Damage Due to Arthritis
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Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- The thigh and shin bones do not fuse as they should
Things that may raise the risk of problems are:
- Smoking
- Alcohol use disorder
- Chronic diseases, such as diabetes or obesity
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- The medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting, such as avoiding food or drink after midnight the night before
- Arranging a ride to and from surgery
- Tests that will need to be done before surgery, such as images of the knee
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
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, 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.
How Long Will It Take?
About 2 hours
Will It Hurt?
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can help.
Average Hospital Stay
You may be able to go home in 3 to 4 days. If you have problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give you pain medicine
- Protect the knee with a splint or brace
- Teach you how to use crutches
At Home
It will take a few weeks for the incisions to heal. Full recovery can take 3 months. Physical activity will need to be limited at first. You will need to ask for help with daily activities and delay your return to work.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, more pain, a lot of bleeding, or any leaking from the incision
- Pain that you cannot control with medicine
- Cough, shortness of breath, or chest pain
- Nausea or vomiting
- Numbness or tingling in the lower leg
If you think you have an emergency, call for medical help right away.
Resources:
Arthritis Foundation
http://www.arthritis.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org
Canadian Resources:
The Arthritis Society
http://www.arthritis.ca
Canadian Orthopaedic Association
http://www.coa-aco.org
REFERENCES:
Bratzler DW, Dellinger EP, et al; American Society of Health-System Pharmacists, Infectious Disease Society of America, Surgical Infection Society, Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013 Feb 1;70(3):195-283.
Surgical site infection-prevention. EBSCO DynaMed website. Available at:https://www.dynamed.com/prevention/surgical-site-infection-prevention. Updated November 4, 2019. Accessed July 17, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 4/9/21