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Knee Arthrodesis with Internal Fixation

knee AR-throw-DEE-sis

 

Definition

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.

 

Reasons for Procedure    TOP

Knee arthrodesis may only be done if all other repair methods have failed or are in appropriate. It may be done:

  • After a failed knee replacement
  • In patients with chronic joint infections that have led to severe knee damage
  • In patients with debilitating pain that cannot be resolved by other treatment options

Knee arthitis

Joint Damage Due to Arthritis

Copyright © Nucleus Medical Media, Inc.

Arthrodesis may reduce pain and improve overall function. However, it will prevent bending at the knee and will cause a limp.

 

Possible Complications    TOP

Your doctor will review a list of possible complications, which may include:

  • Excess bleeding
  • Adverse reaction to anesthesia
  • Infection
  • Blood clots
  • Loosening of components in patients with poor bone quality
  • The thigh and shin bones do not join together as expected

Factors that may increase the risk of problems include:

  • Smoking
  • Some chronic diseases, like obesity or diabetes
  • Heavy alcohol use

Make sure you talk to your doctor about these risks before your procedure.

 

What to Expect    TOP

Prior to Procedure

Your doctor may do the following before your procedure:

  • Imaging tests, like x-rays or scans
  • Electrocardiogram for heart function
  • Have you donate blood in case you need a transfusion
  • Prescribe 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.

Anesthesia

General anesthesia will be used. You will be asleep during the surgery.

Description of the Procedure    TOP

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.

How Long Will It Take?    TOP

About 2 hours

Will It Hurt?    TOP

Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.

Average Hospital Stay    TOP

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.

Post-procedure Care    TOP

At the Hospital

Right after the procedure, you may be given medication such as:

  • Pain medication
  • Antibiotics to prevent infection
  • Medication 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.

At Home

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    TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications such as:

  • Signs of infection such as fever or chills
  • Problems at the incision site such as redness, swelling, pain, bleeding, or draining
  • Nausea or vomiting
  • Pain that does not go away with the pain medication you have been given
  • Numbness or tingling in the lower leg
  • Chest pain or trouble breathing

If you have an emergency, call for emergency medical services 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:

Bono James, Talmo Carl, et al. Arthrodesis of the Knee: Indications and Treatment Options. Techniques in Knee Surgery. 2009;8(4):212-215.

Fusion (arthrodesis). Knee 1 website. Available at:
...(Click grey area to select URL)
Updated October 26, 2001. Accessed February 9, 2018.

Knee Arthrodesis. Bone and Spine website. Available at:
...(Click grey area to select URL)
Accessed February 9, 2018.

Surgical site infection-prevention. EBSCO DynaMed website. Available at: http://www.dynamed.com/topics/dmp~AN~T316886/Surgical-site-infection-prevention . Updated October 3, 2017. Accessed February 9, 2018.

Talmo CT, Bono JV, et al. Intramedullary Arthrodesis of the Knee in the Treatment of Sepsis after TKR. HSS J. 2007;3(1):83-88.



Last reviewed March 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 6/24/2013

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