What is arthrodesis/fusion surgery for the hip?

Arthrodesis means the surgical fusion of joint surfaces, commonly in the knee, spine or hip. The process may include inserting surgical pins, plates and screws for permanent support.  The goal of arthrodesis is to restore, strengthen and stabilize a weak hip joint. However, doctors rarely do the procedure now. Today, surgeons commonly perform hip replacement surgery with artificial joints, and perform hip fusion on rare occasions. 

Why is arthrodesis done on the hip?

For many years, arthrodesis was the only way to give a patient with a severely arthritic or injured hip any mobility. The surgery did limit hip motion. Patients who had the surgery would walk with an awkward gait. Because the hip couldn't move naturally, a patient would stress the back or knee muscles and bones. Here are the conditions that might require a patient to undergo hip fusion:

  • Arthritis
  • Osteoarthritis
  • Osteoporosis
  • Tuberculous arthritis

What to expect during arthrodesis of the hip

The arthrodesis surgery fuses the femur to the pelvis with a large plate and screws — eliminating the joint. The result is a single bone from the pelvis to the knee.  A bone graft may be necessary to fill in an area. You'll be under general anesthesia during surgery. Although it isn't as complex as a hip replacement, it takes a long time to heal from hip fusion surgery. 

Rare reasons that could require arthrodesis

Doctors perform hip fusion in some parts of the world where hip replacement parts are unavailable. Here are other reasons why arthrodesis hip fusion surgery would be necessary:

  • You're too ill for a hip replacement.
  • You've had a failed hip replacement.
  • Your hip replacement has become infected. 
  • You're elderly and a hip replacement isn't ideal for your lifestyle.
  • You have an infection of the femoral head preventing hip replacement. 
  • You're young with a lifestyle or job where you'd wear out an artificial joint very quickly. 
  • You have a history of intravenous substance abuse, which may cause a hip replacement infection.

Total hip replacement has a good outcome for most patients. However, arthrodesis is an option if you can't tolerate a complex hip replacement.

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