Knee Arthrodesis with Internal Fixation

knee AR-throw-DEE-sis

by Cynthia M. Johnson, MA

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

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.dyname.... 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

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.