Canis ISSN: 2398-2942

Arthrodesis: overview

Introduction

  • Fusing a joint prevents painful movement.
  • Usually a salvage procedure where other treatments have failed.

Uses



Conditions resulting in intractible joint pain and/or instability
  • Acquired
    • Traumatic
    • Primary (idiopathic) arthritis.
    • Secondary (immune-mediated) arthritides , but not if severe involvement of multiple joints.
    • Septic arthritis (end stage) Arthritis: infective.
    • Congenital
    • Developmental
      • Dysplasia.
      • Patella luxation.
      • Joint incongruity (secondary to early physeal closure).


      Conditions not directly affecting joints
      • Primary bone tumors Bone: neoplasia.
      • Quadriceps muscle contracture.
      • Peripheral neuropathies.

      Careful assessment of other joints essential - prognosis poor when significant pathology in multiple joints

Advantages

  • The presence of infection does not obviate the use of this technique.
    Infection must be controlled in conjunction with surgery
  • Open injuries with extensive bone and soft tisssue loss can be managed after arthrodesis with the use of external fixators.

Disadvantages

  • Implants may fail prior to joint fusion.
  • Elimination of joint movement may adversely affect other joints or bones in limb resulting in DJD or fractures, especially elbow/stifle, large/active breeds.
  • Ends of plates or screw holes may act as stress risers, in combination with long lever arms: may lead to fractures.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Generally good - extent of limb recovery depends on specific joint involvement.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Franch J, Pastor J, Torrent E et al (2004) Management of leishmanial osteolytic lesions in a hypothyroid dog by partial tarsal arthrodesis. Vet Rec 155 (18), 559-562 PubMed.
  • Dyce J, Whitelock R G, Robinson K G et al (1998) Arthrodesis of the tarsometatarsal joint using a laterally applied plate in 10 dogs. JSAP 39 (1), 19-22 PubMed.
  • Edinger D T, Manley P A(1998) Arthrodesis of the shoulder for synovial osteochondrosis. JSAP 39 (8), 397-400 PubMed.
  • Rochat M C, Mann F A (1998) Metatarsaopharlangeal arthrodesis in three dogs. J Am Anim Hosp Assoc 34 (2), 158-163 PubMed.
  • Cook J L, Payne J T (1997) Surgical treatment of osteoarthritis. Vet Clin North Am Small Anim Pract 27 (4), 931-944 PubMed.
  • Seguin B, Harari J, Wood R D et al (1997) Bone fracture and sequestration as a complications of external skeletal fixation. JSAP 38 (2), 81-84 PubMed.


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