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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 Apr 2023Intercarpal arthrodesis is a well-established option to treat various disorders of the carpus, such as localized osteoarthritis, carpal instability, and Kienböck's... (Review)
Review
Intercarpal arthrodesis is a well-established option to treat various disorders of the carpus, such as localized osteoarthritis, carpal instability, and Kienböck's disease. This is a non-conservative procedure aimed at obtaining a stable and congruent interface between the radius and the proximal carpal row, which restores wrist function by minimizing pain and restoring grip strength. These procedures generally yield good predictable results that are maintained over time. However, all intracarpal arthrodesis procedures cause a loss of wrist range of motion. To optimize outcomes and minimize complications, especially nonunion, this surgery may require a learning curve. A precise surgical technique for preparing the bone surfaces, bringing enough bone graft, and using reliable fixation is essential. Since the late 1960s, several intracarpal arthrodesis procedures have been described. Commonly used fusions target the scaphotrapeziotrapezoid, scaphocapitate, four corners, capitolunate or capitohamatolunate regions. Lesser used fusions focus on specific lesions such as the scapholunate, scapholunocapitate, lunotriquetral and triquetrohamate. Here, we propose a systematic review of the various types of intercarpal arthrodesis procedures described in the literature. After having described each arthrodesis, we specify their indications, the variations of the surgical techniques, and then present an overview of the results and complications. Finally, we discuss how these surgeries affect wrist biomechanics. LEVEL OF EVIDENCE: III.
Topics: Humans; Carpal Bones; Wrist Joint; Wrist; Osteoarthritis; Arthrodesis
PubMed: 36642245
DOI: 10.1016/j.hansur.2022.12.006 -
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 -
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 -
Foot and Ankle Clinics Mar 2011Tibiotalocalcaneal (TTC) arthrodesis is a salvage operation to treat a difficult problem; normal function is not expected with arthrodesis of these 2 major joints.... (Review)
Review
Tibiotalocalcaneal (TTC) arthrodesis is a salvage operation to treat a difficult problem; normal function is not expected with arthrodesis of these 2 major joints. However, in properly selected patients, TTC arthrodesis using intramedullary nailing is an effective technique to reduce pain and improve function. It allows load sharing, provides anatomic alignment, and has the advantage of being able to simultaneously arthrodese both the joints with 1 device. Its use is not without risks, and care must be taken when choosing the insertion site to reduce the risk of neurovascular insult.
Topics: Ankle Joint; Arthrodesis; Humans; Internal Fixators; Joint Diseases; Patient Selection; Tarsal Joints
PubMed: 21338935
DOI: 10.1016/j.fcl.2010.12.001 -
Hand Clinics Nov 2017Partial wrist arthrodesis (PWA) is a well-known procedure for treating degenerative or posttraumatic wrist conditions. Four-corner fusion (4CF) is mostly used for... (Review)
Review
Partial wrist arthrodesis (PWA) is a well-known procedure for treating degenerative or posttraumatic wrist conditions. Four-corner fusion (4CF) is mostly used for scapholunate advanced collapse and scaphoid nonunion advanced collapse. The author performed 39 procedures, including 4CFs, 2-corner fusions, 3-corner fusions, scaphoid-capitate/scaphoid-capitate-lunate fusions, scaphoid-trapezium-trapezoid arthrodeses, and radioscapholunate arthroscopic PWAs (A-PWAs). There were 8 revision cases including 4 partial nonunions. All A-PWAs healed satisfactorily after revision surgery. This article discusses the surgical techniques and tips to avoid mistakes. The pros and cons for open versus arthroscopic techniques and for screws versus Kirschner wires are also discussed.
Topics: Arthrodesis; Arthroscopy; Humans; Osseointegration; Postoperative Care; Postoperative Complications; Preoperative Care; Wrist Joint
PubMed: 28991585
DOI: 10.1016/j.hcl.2017.07.013 -
Der Orthopade May 2017The tarso-metatarsal 1 joint (TMT-I) arthrodesis is a treatment option or moderate to severe hallux valgus (HV) deformities. Instability of the TMT1 joint is still... (Review)
Review
The tarso-metatarsal 1 joint (TMT-I) arthrodesis is a treatment option or moderate to severe hallux valgus (HV) deformities. Instability of the TMT1 joint is still a debatable indication. Using stable osteosynthesis techniques allows early postoperative weight bearing. Plantar plating combined with a lag screw is the biomechanical most stable construct. An additional intermetatarsal screw can improve the horizontal stability. Clinical results are good and radiological parameters stay constant, even in the long term.
Topics: Arthrodesis; Evidence-Based Medicine; Hallux Valgus; Humans; Joint Instability; Metatarsal Bones; Metatarsophalangeal Joint; Osteotomy; Plastic Surgery Procedures; Treatment Outcome
PubMed: 28361194
DOI: 10.1007/s00132-017-3411-9 -
Knee Surgery, Sports Traumatology,... Aug 2014Primary stability in arthrodesis of the knee can be achieved by external fixation, intramedullary nailing or plate fixation. Each method has different features and... (Review)
Review
PURPOSE
Primary stability in arthrodesis of the knee can be achieved by external fixation, intramedullary nailing or plate fixation. Each method has different features and results. We present a practical algorithm for arthrodesis of the knee following a failed (infected) arthroplasty, based on our own results and a literature review.
METHODS
Between 2004 and 2010, patients were included with an indication for arthrodesis after failed (revision) arthroplasty of the knee. Patients were analyzed with respect to indication, fusion method and bone contact. End-point was solid fusion.
RESULTS
Twenty-six arthrodeses were performed. Eighteen patients were treated because of an infected arthroplasty. In total, ten external fixators, ten intramedullary nails and six plate fixations were applied; solid fusion was achieved in 3/10, 8/10 and 3/6, respectively.
CONCLUSIONS
There is no definite answer as to which method is superior in performing an arthrodesis of the knee. Intramedullary nailing achieved the best fusion rates, but was used most in cases without--or cured--infection. Our data and the contemporary literature suggest that external fixation can be abandoned as standard fusion method, but can be of use following persisting infection. The Ilizarov circular external fixator, however, seems to render high fusion rates. Good patient selection and appropriate individual treatment are the key to a successful arthrodesis. Based upon these findings, a practical algorithm was developed.
Topics: Aged; Arthrodesis; Arthroplasty, Replacement, Knee; Female; Humans; Knee Joint; Male; Prosthesis-Related Infections; Reoperation; Retrospective Studies; Treatment Failure
PubMed: 23708381
DOI: 10.1007/s00167-013-2539-3 -
Der Unfallchirurg Mar 2022The gold standard in operative treatment of end-stage ankle osteoarthritis remains controversial even now. Endoprosthetic treatment, which has undergone significant... (Review)
Review
The gold standard in operative treatment of end-stage ankle osteoarthritis remains controversial even now. Endoprosthetic treatment, which has undergone significant improvements in recent years competes with arthrodesis, which can achieve excellent results particularly in the arthroscopically assisted technique. Both procedures offer specific advantages and disadvantages so that the decision about indications for treatment should always be made individually, taking specific needs and the individual constellation of findings of the patient into consideration.
Topics: Ankle Joint; Arthrodesis; Arthroplasty, Replacement, Ankle; Humans; Joint Prosthesis; Osteoarthritis; Treatment Outcome
PubMed: 35175404
DOI: 10.1007/s00113-022-01145-4 -
Clinics in Podiatric Medicine and... Jul 2021Cavus foot is a complex podiatric deformity that requires precise and in-depth work-up through an objective, physical, and radiographic examination. The goal of surgical... (Review)
Review
Cavus foot is a complex podiatric deformity that requires precise and in-depth work-up through an objective, physical, and radiographic examination. The goal of surgical treatment is to eliminate pain while establishing a plantigrade foot structure. Triple arthrodesis has proven to be an effective surgical procedure for treatment of moderate to severe rearfoot deformity with or without the presence of rearfoot arthritic changes. The foot and ankle surgeon must always be aware that no two cavus deformity cases are alike, therefore one may require additional surgical procedures including soft tissue balancing, joint-sparing osteotomies, and/or supplementary arthrodesing procedures.
Topics: Arthrodesis; Conservative Treatment; Foot; Humans; Physical Examination; Postoperative Care; Radiography; Talipes Cavus; Tarsal Joints
PubMed: 34053652
DOI: 10.1016/j.cpm.2020.12.014