The document discusses arthrodesis, which is the surgical fusion of a joint. It provides indications and contraindications for various joint arthrodesis procedures, including shoulder, elbow, wrist, hip, knee, and ankle. Common indications are infection, trauma, instability, and failed joint replacements. Contraindications include active infection and conditions that require joint mobility. The positions for fixation of different joints are also outlined.

1. ARTHRODESIS
INDICATIONS & CONTRAINDICATIONS
Dr. Pawan K. Yadav
D.ORTHO.,DNB(ORTHO)
BIRRD HOSPITAL, TIRUPATHI

2. ARTHRODESIS
“Bony fusion of a diseased joint”

3. “ Satisfactory solution for infection, tumors,
trauma, and paralytic conditions and in certain
cases of osteoarthritis and rheumatoid arthritis
to relieve pain, joint instability ”

4. INDICATIONS
•Sepsis, articular Tuberculosis, and Instability
caused by poliomyelitis.

5.  Indications for shoulder fusion have
diminished over the years because of:
 excellent results of shoulder arthroplasty
 the near elimination of poliomyelitis and TB
 improved tech. shoulder stabilization.
SHOULDER ARTHRODESIS

7.  Infection
 Post traumatic brachial plexus palsy
 Recurrent dislocation
 Massive unreconstrutble rotator cuff tear
 Failed shoulder arthroplasty
 Stabilization after neoplastic lesion
SHOULDER ARTHRODESIS
INDICATIONS

8. Osteonecrosis
Charcot arthropathy
Ipsilateral elbow fusion
Contralateral shoulder fusion
SHOULDER ARTHRODESIS
CONTRAINDICATIONS

9.  Infection
 Post traumatic arthritis
 Failed elbow arthroplasty
 Severly comminuted intra articular #
ELBOW ARTHRODESIS
INDICATIONS

10. Osteonecrosis
Charcot arthropathy
Ipsilateral elbow fusion
Contralateral shoulder fusion
ELBOW ARTHRODESIS
CONTRAINDICATIONS

11.  Infection
 Post traumatic arthritis
 Failed elbow arthroplasty
 Spastic hemiplegia
 Wrist / Hand paralysis
WRIST ARTHRODESIS
INDICATIONS

12. An open physis of the distal radius(17
years of age).
After partial destruction of the physis
,the remaining part may be excised to
prevent unequal growth.
An elderly patient with a sedentary
lifestyle, especially if the nondominant
wrist is involved.
WRIST ARTHRODESIS
CONTRAINDICATIONS

13.  desire to return to near-normal physical
activity with manual labor;
 20 yrs years after surgery, 80% of pts w/ hip
arthrodesis performed at relatively young age
were working & satisfied w/ their results.
HIP ARTHRODESIS
INDICATIONS

14. Osteonecrosis
Charcot arthropathy
HIP ARTHRODESIS
CONTRAINDICATIONS

15.  Infection
 Post traumatic arthritis
 Failed elbow arthroplasty
 Severly comminuted intra articular #
KNEE ARTHRODESIS
INDICATIONS

17. bilateral knee disease
ipsilateral ankle or hip disease
severe segmental bone loss;
contralateral leg amputation;
KNEE ARTHRODESIS
CONTRAINDICATIONS

18.  Severe Valgus/Varus foot deformities
 Collapsing pes planovalgus deformity
 Tibialis posterior tendon dysfunction
 Tarsal coalition
 Rheumatoid arthritis (RA)
 Degenerative arthritis (e.g., DJD)
 Posttraumatic arthritis & Chronic pain
 Joint instability
ANKLE ARTHRODESIS
INDICATIONS

19. Osteonecrosis
Charcot arthropathy
CHRONIC SMOKING
ANKLE ARTHRODESIS
CONTRAINDICATIONS

20. • SHOULDER hand can comfortably reach the mouth. Arthrodesis of shoulder joint is
usually reserved for a flail joint as may follow a brachial plexus injury.
• ELBOW 90° of flexion .
• WRIST A few degree of extension
• THUMB MCP joint in 20° of flexion. IP joint in slight flexion.
FIXATION POSITIONS