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Benefits and Risks
Before Surgery
Non Orthopedic Surgery
Orthopedic Surgery
After Surgery
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MAJOR AND MINOR ORTHOPEDIC SURGERY
Because of frequent joint bleeds, minor and major orthopedic procedures are the most common elective procedures needed in people with hemophilia A or B with inhibitors. To learn more about your surgical procedure, select from the options in the drop down menu below.
 
ANKLE JOINT FUSION

Elbow ReplacementJoint fusion or arthrodesis involves joining the bones to relieve pain. The two bones are permanently joined together with screws, steel rods, or staples. The joint is no longer flexible so this procedure is usually done for specific joints like the ankle, or if special circumstances make it more appropriate than joint replacement.

You will be admitted to the hospital for the procedure, which is usually performed under general or spinal anesthesia (epidural). The procedure may take 2 to 5 hours, depending on the number of joints being fused.

During ankle joint fusion (arthrodesis) the main lower leg bone (tibia) is joined or fused to the ankle bone (talus). There are a number of ways to fuse the ankle: long screws, screws and steel plates, long steel rods, bone grafts, or an external device called a fixator. The surgery may be performed with an arthroscope or as an open procedure. After the operation, you may be able to go home after a few days to a week, depending on how your recovery is progressing.

Factor replacement therapy will be needed before, during, and after the procedure. Pain medication will likely be prescribed. It takes about 10 to 12 weeks after surgery for the bones to solidly join.13 During this time your ankle will be immobilized in a cast. During the first 6 weeks you should not put any weight on the joint.2

As with other surgeries possible complications include bleeding or infections. Occasionally the joint may not solidly fuse, or may not be aligned properly, causing pain, an altered gait, or repeat surgery. Once the bones fuse, the joint is no longer flexible, but you will have decreased pain and increased functioning; the joint may bear weight better and is more stable.

X-ray image courtesy of Hemophilia Treatment Center at Orthopedic Hospital, Los Angeles. Courtesy of James V Luck and Mauricio Silva
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