27871 Arthrodesis, tibiofibular joint, proximal or distal

Name of the Procedure:

Arthrodesis of the Tibiofibular Joint (Proximal or Distal) Common names: Tibiofibular joint fusion

Summary:

Arthrodesis of the tibiofibular joint involves surgically fusing the tibia and fibula at either the proximal (near the knee) or distal (near the ankle) ends. The procedure aims to eliminate pain and provide stability to the joint by encouraging the bones to grow together as a single, solid structure.

Purpose:

Medical conditions addressed:

• Chronic pain or instability in the tibiofibular joint
• Severe arthritis
• Post-traumatic joint damage

Goals:

• Alleviation of pain
• Enhanced joint stability and functionality

Indications:

Symptoms and Conditions:

• Persistent pain not responsive to conservative treatments
• Joint instability
• Severe degenerative changes in the joint due to arthritis
• Recurrent subluxations or dislocations

Patient Criteria:

• Patients who have tried and failed conservative therapies (e.g., medications, physical therapy, bracing)
• Generally good overall health to tolerate surgery

Preparation:

• Follow fasting instructions as advised by the surgeon (typically no food or drink for 8-12 hours before surgery).
• Stop certain medications (e.g., blood thinners) as directed.
• Preoperative assessment may include imaging studies (X-rays, MRI), blood tests, and a physical examination.

Procedure Description:

1. Anesthesia: General anesthesia is typically administered.
2. Incision: A surgical incision is made over the tibiofibular joint.
3. Preparation of Joint Surfaces: Damaged cartilage is removed, and the bone surfaces are prepared to promote fusion.
4. Bone Grafting: Bone graft material may be placed between the tibia and fibula to enhance fusion.
5. Fixation: The bones are secured using metal plates, screws, or rods.
6. Closure: The incision is closed using sutures or staples, and a sterile dressing is applied.

Duration:

The procedure typically takes 1 to 3 hours, depending on the complexity and specific surgical approach.

Setting:

Arthrodesis of the tibiofibular joint is generally performed in a hospital or surgical center.

Personnel:

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications:

Common Risks:

• Infection
• Blood clots
• Nerve damage

• Nonunion (failure of the bones to fuse)

  Rare Risks:

• Anesthetic complications
• Chronic pain

Management:

• Prophylactic antibiotics
• Postoperative imaging to monitor bone healing
• Pain management and physical therapy if needed

Benefits:

Expected Benefits:

• Relief from joint pain
• Improved joint stability
• Enhanced mobility and functionality

Realization Time:

• Full benefits are commonly experienced within 3 to 12 months post-surgery.

Recovery:

Post-procedure care:

• Immobilization with a cast or boot
• Pain management with prescribed medications
• Physical therapy to regain strength and mobility

Recovery Time:

• Initial recovery: 6-12 weeks for bone healing
• Full recovery: Up to 12 months including physical rehabilitation

Restrictions:

• Limited weight-bearing on the affected leg initially
• Gradual increase in activity as approved by the surgeon
• Follow-up appointments for progress assessment

Alternatives:

Other Treatment Options:

• Conservative management with physical therapy, medications, and bracing
• Pain management injections (e.g., corticosteroids)
• Partial joint replacement (in some cases)

Comparison:

• Conservative treatments are less invasive but may not provide long-term relief.
• Joint replacement may offer symptom relief but comes with different risks and longevity concerns.

Patient Experience:

During the Procedure:

• Under general anesthesia, the patient will be unconscious and not feel any pain.

After the Procedure:

• Postoperative pain managed with medications
• Temporary discomfort due to incision and immobilization
• Gradual improvement as bone healing progresses

Pain Management:

• Pain relief through prescribed analgesics
• Non-pharmacological measures like ice application and elevation

Comfort Measures:

• Proper wound care to prevent infection
• Supportive devices like crutches or walkers during the initial recovery phase