Key Points About Knee Arthrodesis (Joint Fusion) 

  • Knee arthrodesis, also known as knee fusion, is a surgery that connects the thigh bone to the shin bone. While knee arthrodesis was widely used in the past, it is only used now as a last resort option if knee replacement has failed or is not an option.
  • The goal of knee fusion is to create a stable, immobile joint in order to relieve your debilitating pain.
  • While you will lose flexibility and range of motion in your leg, with physical therapy, you can return to work and most of your normal activities.
  • During the procedure, your doctor will cut the ends of the thigh and shin bones, remove all ligaments, tissues, and joint lining, and push the ends of the bones together and secure them with metal plates and screws.
  • You will likely need to wear a cast for approximately 12 weeks after surgery. It will take six months for you to fully recover and return to your normal routine. 

Knee arthrodesis, also known as knee fusion, is an orthopedic procedure where the leg and thigh bone are fused to eliminate any rotation in the knee joint.

Knee fusion is a last resort treatment to achieve a stable, pain-free knee for patients who are suffering from a knee issues where knee replacement is not an option.

During a knee fusion, your doctor will remove any remaining bone or tissue in the joint and place the shin and thigh bone together. Your doctor will then hold the bones together using metal rods, plates, or screws. The bones need to be held together for several months to enable them to heal.

Who is a Candidate for Knee Arthrodesis?

Your doctor may recommend a knee arthrodesis in the following cases:

  • You have had a failed knee replacement.
  • You are suffering from debilitating knee pain. 
  • A tumor is present around the joint.
  • Arthritis is present from prior trauma.
  • You have a joint or blood infection that has been present for a long time. 

Knee arthrodesis is a last resort option when all other treatments have failed.

Risks associated with Knee Arthrodesis

While knee arthrodesis is a major surgery, it is generally safe. Once the thigh and leg bones fused, the joint is stable and immobile. While you will lose motion and flexibility in the leg, you should not feel pain. 

Complications associated with knee arthrodesis include:

  • Blood clots.
  • Nerve damage.
  • Infection.
  • Mild lower back pain.
  • Arthritis may develop as more stress is passed to the hip.

If you are a smoker, you may experience other complications such as:

  • Pseudoarthrosis where bones do not fuse.
  • Persistent pain.
  • Second surgery if the hardware breaks.

Preparing for Knee Arthrodesis (Knee fusion)

In preparation for surgery, your doctor will give you a list of guidelines to follow to ensure a successful surgery.

Guidelines include:

  • Stop taking medications such as blood thinners a week or more before surgery, as instructed by your doctor. 
  • Inform your doctor of any medications or supplements you are taking. 
  • Prepare your home to be ready for you to move around with a wheelchair, walker, or cane.
  • Coordinate to have someone drive you home after surgery.
  • Do not eat or drink anything after midnight on the day before surgery.

What to Expect During Knee Arthrodesis (Knee Fusion)

Knee arthrodesis is performed in a hospital setting under general anesthesia. During the surgery, your orthopedic surgeon will remove damaged cartilage and bone from the ends of the leg and thigh bones and join the bones with metal plates or rods. 

In some cases, your doctor will remove a piece of your pelvic bone to create a bone graft that will help the bones join. 

The hardware that is used to keep the bones together may stay in place even after the bone heals. 

Duration of Recovery after Knee Arthrodesis (Knee Fusion)

The procedure takes two to three hours. You will likely stay in the hospital for two to four days after the surgery, and some people are discharged to a rehabilitation facility to help with the recovery process.

After discharge, follow your doctor's strict discharge instructions, including:

  • Keep the leg elevated to reduce pain and swelling.
  • Use pain medications exactly as prescribed.
  • Use your crutches to move around.
  • Avoid putting weight on the affected knee for 12 weeks.

You will wear the cast for approximately 12 weeks after surgery. After the cast is removed, you will need a brace for support. During this period, you will need to participate in physical therapy to strengthen and stretch the area.

It can take as long as six months to fully recover from knee arthrodesis.