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The Journal of the American Academy of... Aug 2022Shoulder arthrodesis is an end-stage, salvage procedure for the glenohumeral joint and can provide a pain-free, stable shoulder with varying levels of function. Common...
Shoulder arthrodesis is an end-stage, salvage procedure for the glenohumeral joint and can provide a pain-free, stable shoulder with varying levels of function. Common indications include brachial plexus injury, chronic instability with rotator cuff and deltoid dysfunction, and failed shoulder arthroplasty. Multiple techniques are described, including intra-articular and extra-articular arthrodeses. Fusion can be accomplished with screw fixation, plate fixation, external fixation, and arthroscopic-assisted techniques. The optimal position of the arm is heavily debated in the literature, but the ideal position is thought to be 30° of flexion, 30° of abduction, and 30° of internal rotation. After successful fusion, the patient should be able to bring their hand to their mouth, reach their back pocket, and cross the midline for hygiene. Complications are not uncommon and include nonunion, malunion, fracture, and infection. With the increasing incidence of shoulder arthroplasty, failed arthroplasties are more commonly encountered. In a salvage situation, shoulder arthrodesis may be considered.
Topics: Arthrodesis; Bone Plates; Brachial Plexus; Humans; Range of Motion, Articular; Shoulder; Shoulder Joint; Treatment Outcome
PubMed: 36067462
DOI: 10.5435/JAAOS-D-21-00667 -
The Veterinary Clinics of North... Jan 2020Arthrodesis is an elective surgical procedure that aims at eliminating pain and dysfunction by promoting deliberate osseous fusion of the involved joint(s). Percutaneous... (Review)
Review
Arthrodesis is an elective surgical procedure that aims at eliminating pain and dysfunction by promoting deliberate osseous fusion of the involved joint(s). Percutaneous plating can be used to perform carpal and tarsal arthrodeses in dogs and cats. After cartilage debridement is performed, the plate is introduced through separate plate insertion incisions made remote to the arthrodesis site and advanced along an epiperiosteal tunnel, and screws are inserted through the 3 existing skin incisions. The primary advantage of this technique is a decreased risk of soft-tissue complications, including postoperative swelling, ischemia, and wound dehiscence. Preliminary clinical results have been promising.
Topics: Animals; Arthrodesis; Bone Plates; Fracture Fixation, Internal
PubMed: 31653536
DOI: 10.1016/j.cvsm.2019.08.014 -
Hand Surgery & Rehabilitation Sep 2021Arthrodesis of the trapeziometacarpal (TMC) joint is one of the first surgical procedures used to treat thumb basal joint arthritis. From 1970 to 1990, we performed 254...
Arthrodesis of the trapeziometacarpal (TMC) joint is one of the first surgical procedures used to treat thumb basal joint arthritis. From 1970 to 1990, we performed 254 TMC arthrodeses with crossed K-wires. From 2015 to 2016, we performed 12 TMC arthrodesis procedures with shape-memory staples. The results were evaluated with De La Caffinière's classification and took into account patient satisfaction and any complications. The results were satisfactory overall, without any significant difference between the two fixation methods but with a rather high complication rate. The indication for arthrodesis in surgical treatment of thumb basal joint arthritis is based on the patient's age and occupation. The best indication is a young active patient.
Topics: Arthritis; Arthrodesis; Humans; Patient Satisfaction; Sutures
PubMed: 33401006
DOI: 10.1016/j.hansur.2020.09.010 -
Foot and Ankle Clinics Jun 2022Hallux rigidus can be treated with a variety of surgical procedures, including joint preserving techniques, arthrodesis, and arthroplasty. The most commonly reported... (Review)
Review
Hallux rigidus can be treated with a variety of surgical procedures, including joint preserving techniques, arthrodesis, and arthroplasty. The most commonly reported complications for joint preserving techniques consist of progression of arthritis, continued pain, and transfer metatarsalgia. Although good outcomes have been reported for arthrodesis overall, careful attention must be paid to technique and positioning of the toe to avoid nonunion or malunion. Arthroplasty preserves motion but in the case of failure can present the additional challenge of bone loss. In these scenarios, the authors recommend distraction bone block arthrodesis with structural autograft.
Topics: Arthrodesis; Arthroplasty; Hallux Rigidus; Humans; Metatarsalgia; Metatarsophalangeal Joint
PubMed: 35680287
DOI: 10.1016/j.fcl.2021.11.016 -
Clinics in Podiatric Medicine and... Oct 2017First described in 1879, ankle arthrodesis is a procedure that has undergone significant advancements not only in technique but also in technology and fixation. Surgeon... (Review)
Review
First described in 1879, ankle arthrodesis is a procedure that has undergone significant advancements not only in technique but also in technology and fixation. Surgeon preference has often dictated those changes with regard to incisional approaches, fixation methods, and use of bone graft and biologics but one constant has always remained: open ankle arthrodesis is a predictable, time-tested procedure with consistent results when performed in appropriate patients. This article highlights the changes that have occurred since the introduction of this procedure and provides a brief overview of the preferred technique.
Topics: Ankle Injuries; Ankle Joint; Arthrodesis; Biological Products; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Joint Diseases; Osteoarthritis
PubMed: 28867055
DOI: 10.1016/j.cpm.2017.05.006 -
The Journal of the American Academy of... Sep 2018Fractures of the distal tibial plafond (ie, pilon) comprise a broad range of injury mechanisms, patient demographics, and soft-tissue and osseous lesions. Patients often... (Review)
Review
Fractures of the distal tibial plafond (ie, pilon) comprise a broad range of injury mechanisms, patient demographics, and soft-tissue and osseous lesions. Patients often present with considerably comminuted fracture patterns and notable soft-tissue compromise. Surgical intervention must be performed with respect for the exceedingly vulnerable soft-tissue envelope and with a properly executed technique. Even with proper timing, favorable host factors, and expert surgical technique, restoration of function and avoidance of complications are not always achievable. Recently validated techniques further diminish the risk of soft-tissue and osseous sepsis. These techniques include early (ie, "immediate") fixation, upgrading, primary arthrodesis, staged sequential posterior and anterior fixation, acute shortening, and transsyndesmotic fibular plating. Proper application of these recently adopted techniques may be instrumental in achieving aseptic union of pilon fractures.
Topics: Arthrodesis; Bone Plates; Fracture Fixation; Humans; Postoperative Complications; Soft Tissue Injuries; Tibial Fractures
PubMed: 30134307
DOI: 10.5435/JAAOS-D-17-00160 -
Foot and Ankle Clinics Mar 2024The debate between ankle arthrodesis and total ankle replacement for patients with end-stage arthritis of the ankle joint is an ongoing topic in orthopedic surgery.... (Review)
Review
The debate between ankle arthrodesis and total ankle replacement for patients with end-stage arthritis of the ankle joint is an ongoing topic in orthopedic surgery. Ankle arthrodesis, or fusion, has been the traditional treatment for ankle arthritis. It involves fusing the bones of the ankle joint together, eliminating the joint and creating a solid bony union. Arthrodesis is effective in reducing pain in the ankle, but it results in a loss of ankle motion. This can increase the load on adjacent joints, such as the subtalar joint, which may lead to accelerated degeneration and arthritis in those joints over time.
Topics: Humans; Arthroplasty, Replacement, Ankle; Treatment Outcome; Ankle Joint; Ankle; Arthritis; Subtalar Joint; Arthrodesis; Retrospective Studies
PubMed: 38309799
DOI: 10.1016/j.fcl.2023.08.007 -
Foot and Ankle Clinics Mar 2019This article reviews the surgical treatment of talar avascular necrosis. Specifically, arthrodesis for this complex entity and potential treatment of nonunions are... (Review)
Review
This article reviews the surgical treatment of talar avascular necrosis. Specifically, arthrodesis for this complex entity and potential treatment of nonunions are discussed. The hallmarks of treatment are evolving and can range from nonoperative measures to amputations. Nonoperative treatment and the results of current arthrodesis techniques for late-stage avascular necrosis are reviewed. Surgical correction requires an understanding of the condition's natural history, utilization of structural and nonstructural bone grafting techniques, and stable fixation. Although the methods described follow standard orthopedic principles, high-quality evidence and outcome studies are limited for treatment of this challenging and often disabling condition.
Topics: Ankle Joint; Arthrodesis; Humans; Osteonecrosis; Postoperative Complications; Talus; Treatment Outcome
PubMed: 30685007
DOI: 10.1016/j.fcl.2018.11.004 -
Clinics in Podiatric Medicine and... Jul 2015We present a discussion on the use of proximal first-ray osteotomies in the surgical treatment for hallux valgus as a valid option compared with first-tarsometatarsal... (Review)
Review
We present a discussion on the use of proximal first-ray osteotomies in the surgical treatment for hallux valgus as a valid option compared with first-tarsometatarsal arthrodesis. Recent and historical literature tells us that stability of the first ray is a function of the alignment and reestablishment of retrograde stabilizing forces at the first tarsometatarsal joint. This realignment and stabilization may be accomplished with the use of distal soft tissue and proximal osteotomy procedures.
Topics: Arthrodesis; Hallux Valgus; Humans; Osteotomy
PubMed: 26117572
DOI: 10.1016/j.cpm.2015.03.009 -
The Journal of the American Academy of... Jun 2016Instrumentation of the cervical spine enhances stability and improves arthrodesis rates in children undergoing surgery for deformity or instability. Various morphologic... (Review)
Review
Instrumentation of the cervical spine enhances stability and improves arthrodesis rates in children undergoing surgery for deformity or instability. Various morphologic and clinical studies have been conducted in children, confirming the feasibility of anterior or posterior instrumentation of the cervical spine with modern implants. Knowledge of the relevant spine anatomy and preoperative imaging studies can aid the clinician in understanding the pitfalls of instrumentation for each patient. Preoperative planning, intraoperative positioning, and adherence to strict surgical techniques are required given the small size of children. Instrumentation options include anterior plating, occipital plating, and a variety of posterior screw techniques. Complications related to screw malposition include injury to the vertebral artery, neurologic injury, and instrumentation failure.
Topics: Arthrodesis; Bone Plates; Bone Screws; Cervical Vertebrae; Child; Humans; Patient Positioning; Postoperative Complications
PubMed: 27097300
DOI: 10.5435/JAAOS-D-15-00199