arthrodesis


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arthrodesis

 [ahr″thro-de´sis]
artificial ankylosis; surgical fusion of a joint.

ar·throd·e·sis

(ar-throd'ĕ-sis, ar-thrō-dē'sis),
The stiffening of a joint by operative means.
[arthro- + G. desis, a binding together]

arthrodesis

/ar·thro·de·sis/ (-de´sis) the surgical fixation of a joint by a procedure designed to accomplish fusion of the joint surfaces by promoting the proliferation of bone cells; called also artificial ankylosis.

arthrodesis

(är-thrŏd′ĭ-sĭs, är′thrə-dē′sĭs)
n. pl. arthrode·ses (-sēz)
The surgical fixation of a joint to promote bone fusion, used to treat intractable pain.

arthrodesis

surgical fusion of a joint. See ankylosis.

arthrodesis

The creation of a bony union across a joint, which can be either spontaneous or surgical.

Sites of surgical arthrodesis, best joints
Ankle, knee, shoulder, hip.
 
Indications
Differ according to the joint: ankle arthrodesis is performed for osteoarthritis, rheumatoid arthritis and post-traumatic arthritis; arthrodesis of the knee is usually performed as a last resort for infections (such as TB or neuropathic joint secondary to diabetes or syphilis), given the compromise in mobility that it causes.

Technique
Joints are denuded of cartilage, then shaped to conform to each other at the optimal angle; bone grafting is often used, as is some form of fixation, either internal (screws, rods, plates) or external (e.g., with a cast or external fixator).

arthrodesis

Joint fusion Orthopedics The creation of a bony union across a joint, which can be spontaneous or surgical; best arthrodesis joints: ankle, knee, shoulder, hip Indications Differ according to the joint; ankle arthrodesis is performed for osteoarthritis, rheumatoid arthritis, and posttraumatic arthritis; arthrodesis of the knee is usually performed as a last resort, given the compromise in mobility that it causes–eg sitting on airplanes or in movies, for infections–eg, TB or neuropathic joint 2º to DM or syphilis. See Chamley arthrodesis.

ar·thro·de·sis

(ahr-thrō'dē-sis)
The stiffening of a joint by operative means.
Synonym(s): artificial ankylosis, syndesis.
[arthro- + G. desis, a binding together]

arthrodesis

The fusion of the bones on either side of a joint so that no joint movement is possible. This may occur spontaneously, as a result of disease processes, or may be a deliberate surgical act done to relieve pain and improve function.

arthrodesis

surgical or pathological joint fusion, e.g. first metatarsophalangeal joint fusion in hallux rigidus (see Table 1) or subsequent to gout
Table 1: Classification of stage of hallux limitus/rigidus
StageCharacteristics
Stage 1
Functional HL
∼60° available dorsiflexion at 1 MTPJ
Functional (weight-bearing) limitation of dorsiflexion at 1 MTPJ, with:
• 1 MTPJ painful under load
• Hypermobility of first ray
• No real joint deterioration, but some osteophytosis
• Non-weight-bearing 1 MTPJ dorsiflexion near normal
Stage 2
Mild structural HL
35-55° available dorsiflexion at 1 MTPJ
Structural limitation of dorsiflexion at 1 MTPJ
• 1 MTPJ painful after exercise/movement
• Broadening and flattening of 1 MTPJ surfaces
• Narrowing of 1 MTPJ space
• Moderate osteophytosis of 1 MTPJ area
• Local bone sclerosis
• Elevation of the first ray
• Sesamoid hypertrophy
• Reduced 1 MTPJ dorsiflexion (weight- and non-weight-bearing)
• Reduced heel lift
• 1 MTPJ crepitus
Stage 3
Moderate structural HL
15-30° available dorsiflexion at 1 MTPJ
Structural loss of dorsiflexion at 1 MTPJ
• Pain within 1 MTPJ
• Marked 1 MTPJ deterioration
• Loss of 1 MTPJ space
• Extensive osteophytosis
• Bone sclerosis
• Cystic degeneration of subchondral bone
• Joint 'mice'
• Hypertrophy of sesamoids
• Elevation of the first ray
• Loss of height of MLA
• Decreased calcaneal angle
• 1 MTPJ crepitus
• Marked reduction of heel lift
Stage 4
Severe HR
<15° available dorsiflexion at 1 MTPJ
1 MTPJ immobility
• 1 MTPJ ankylosis and loss of joint space
• Marked osteophytosis and increased bulk of 1 MTPJ
• Loss of heel lift and/or hyperextension of IPJ of hallux

1 MTPJ, first metatarsophalangeal joint; MLA, medial longitudinal arch; IPJ, interphalangeal joint.

arthrodesis

surgical fusion of a joint.
Enlarge picture
Arthrodesis of the scapulohumeral joint. By permission from Slatter D, Textbook of Small Animal Surgery, Saunders, 2002

pancarpal arthrodesis
fusion of all carpal joints.
References in periodicals archive ?
Predicting morbidity and mortality of lumbar spine arthrodesis in patients in their ninth decade.
Ertapenem 4 g + Pseudomonas Refobacin aeruginosa Patient age/gender Second spacer Outcome antibiotics (if performed) 68/female Reimplantation LCCK 57/male Ertapenem 4 g + Reimplantation, RH Refobacin Knee 59/female Reimplantation LCCK 73/female Reimplantation LCCK 77/female Reimplantation LCCK 63/female Ertapenem 4 g + Reimplantation, RH Refobacin Knee 72/male Reimplantation LCCK 76/male Vancomycin 2 g + Knee arthrodesis Refobacin 62/female Reimplantation LCCK 64/male Knee arthrodesis 71/female Reimplantation, RH Knee 55/female Vancomycin 2 g + Persistent Refobacin infection.
Revision Knee Arthroplasty and Arthrodesis of the Knee, Chapman's Orthopedic Surgery, 3rd edition Lippincott Williams & Wilkins, 109: 2897-2949.
Other treatment options are closed reduction, open reduction, heavy traction and abduction, subtrochanteric osteotomy, Girdlestone arthroplasty, arthrodesis, endoprosthetic replacement and total hip replacement.
All patients with congenital kyphosis or kyphoscoliosis should be treated by a posterior arthrodesis before the age of 5 years and before the kyphosis exceeds 50 degrees.
The toe may be straightened by osteotomy (surgery to remove part of the bone and realign the ends) or arthrodesis (surgery to fuse the bones of the joint).
Characteristic Reference 1 Peritoneal dialysis, (2) catheter-related peritonitis 2 Exacerbation of (3) bronchiectasis 3 Disseminated skin infection (4) 4 Chronic endophthalmitis after (5) lens implantation 5 Osteomyelitis after first (6) metatarsophalangeal joint arthrodesis 6 Catheter-related bloodstream (7) infection 7 Catheter-related bloodstream (8) infection
Garcia Stabilization and replacement devices currently used in arthrodesis and arthroplasties of the cervical spine Rev.