What’s the Difference Between Arthrodesis and Arthroplasty?

Arthrodesis is a surgical procedure used to permanently immobilize a joint. Arthroplasty is joint replacement surgery. A joint can be replaced either in whole or in part.

A variety of diseases or injuries might lead you to consider joint surgery. Two types of joint surgeries are arthrodesis and arthroplasty. Each has its own risks, benefits, and uses.

Let’s take a look at which conditions these treatments are commonly used for and when you might want to choose one over the other.

Is arthrodesis the same as fusion?

In most cases, the bones of your affected joint will fuse together after an arthrodesis procedure. For this reason, arthrodesis is sometimes called joint fusion surgery, and the terms can be used interchangeably.

It’s important to note that some conditions, such as ankylosing spondylitis, can cause your joints to fuse together as a complication rather than as intended surgical treatment. This means that arthrodesis is a type of fusion, but not all fusions are the result of arthrodesis.

Injuries are one common cause of joint surgery. In particular, there are many small joints susceptible to injury in your:

Other joints that frequently require surgical treatments include your knees, hips, and spine.

Some diseases can also lead to joint pain and joint damage that might be helped with surgery. Many types of arthritis can lead to surgical treatments. Other types of conditions that might lead you to consider arthrodesis or arthroplasty include:

• osteoporosis and osteopenia
• birth irregularities like clubfoot
• neuromuscular diseases like Parkinson’s disease
• autoimmune conditions like systemic sclerosis

Sometimes you’ll have a choice between arthrodesis and arthroplasty. But, often, one is better suited to treat a particular problem. Let’s first take a look at the potential benefits of each procedure individually.

Arthrodesis benefits

Arthrodesis is often used to treat pain that occurs when you move your joints. The pain could be due to loss of cartilage or other joint damage. Arthrodesis is also used on your ankle or foot to allow for improved mobility, balance, and weight bearing ability.

Arthroplasty benefits

The main benefit of arthroplasty over arthrodesis is maintaining your ability to move your joint. This often makes arthroplasty the preferred surgery for your knees and hips when reduced mobility would be likely to severely affect your daily activities.

All medical procedures come with some level of risk, and these are no exception. The risks of each type of surgery are unique, so let’s see how they compare.

Arthrodesis risks

A fused joint is one that can no longer bend. It’s important to be aware of the effect this might have on your ability to perform routine tasks before undergoing this procedure.

Spinal fusion might affect your posture. Wrist arthrodesis could affect your grip strength or your ability to write or type.

Be sure to speak with the surgeon about expectations before having joint fusion surgery.

Arthroplasty risks

Arthroplasty requires replacing your joint with an artificial joint. Artificial joints can wear out over time just like natural joints and could require future surgeries to repair or replace them.

If the artificial joint contains metal portions that rub together, they could damage your surrounding bones. These metal-on-metal implants are no longer Food and Drug Administration (FDA) approved in the United States though, at least for hips.

Both arthrodesis and arthroplasty are considered to be major surgeries. Let’s take a look at how each one is performed.

Arthrodesis surgery procedure

During this surgery, you’ll likely be given a general anesthetic. This means you’ll be fully asleep. A surgeon will examine your joint and potentially remove any growths that might be causing problems, such as bone spurs.

Then, hardware, such as rods, pins, or plates, will be implanted to keep your joint from moving. During the healing process, the bones on either side of your joint will typically grow into one another, forming one continuous bone.

Arthroplasty procedure

As with bone fusion, you can expect to be given a general anesthetic during a joint replacement surgery.

Surgeons will carefully remove your damaged bone — either partially or in whole — and replace the removed sections with implants that will have similar motion to a healthy joint. Surrounding tissues will be avoided as much as possible.

Because both arthrodesis and arthroplasty are major surgeries, you must be healthy enough to undergo surgery to be a candidate.

Both surgeries also involve implants that you can expect to have for the rest of your life. They’re best reserved for after you’ve tried all other less invasive options. These surgeries are most useful for people with severe joint damage, pain, or both.

The joint that’s causing the problem will generally determine which type of surgery is available to you. Experts generally prefer arthroplasty for your hips and knees, while arthrodesis is more commonly applied to smaller joints.

The cost of both procedures can be variable, but you can expect the total cost to be in the tens of thousands of dollars. Factors affecting the cost could include things like your insurance policy, the state you live in, or the number of similar surgeries the hospital performs.

Because these surgeries are typically deemed medically necessary, most reputable insurance providers will cover at least part of the surgery. This will be dependent on your own provider and plan, so be sure to ask your provider or the hospital’s billing department for details.

If you qualify for government assistance through programs like Medicare or Medicaid, you’ll likely be able to get financial support for these procedures. Again, be sure to check with your provider in advance if possible so you understand the costs that you might be responsible for.

Both procedures are generally considered safe and effective.

A 2020 Brazilian study found that both treatments improved pain for people who had foot surgery. But it was noted that some people had better results when they could keep their range of motion with arthroplasty.

A 2018 study found a 75% satisfaction rate 5 years after a total knee arthroplasty, and wrist arthrodesis has also been described as having a 75% satisfaction rate.

Your results will largely depend on the joint the needs treatment and the cause of your joint pain.

Doctors suggest that these surgical procedures should only be used after other options have already been explored. Depending on the joint and the underlying cause of your joint pain, some nonsurgical treatments could include:

• weight loss
• low-impact exercise
• medication
• cortisone injections
• cartilage implantation
• radiofrequency ablation

Arthrodesis and arthroplasty are both surgical procedures used to treat joint pain and dysfunction due to a variety of underlying conditions.

The type of surgery you qualify for and that is best suited to your situation will depend on which joint needs to be treated and the nature of the damage.

Last medically reviewed on March 23, 2023

How we reviewed this article:

Austra Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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