Our Summary

The research paper tests if using an osteotome (a surgical instrument) or a saw is better in preventing the shortening of the first ray (a part of the foot) during a joint fusion surgery. This surgery is typically performed to treat arthritis and some foot deformities. In the study, they used ten cadaver (dead body) specimens and assigned them randomly to either have the surgery done with an osteotome or a saw. They took X-rays before and after the operation to measure any changes in length. The results showed that the osteotome group had a smaller average change in length compared to the saw group, suggesting that using an osteotome might be better in preventing over-shortening during this kind of surgery.

FAQs

  1. What was the purpose of the research paper about joint fusion surgery?
  2. What surgical instruments were compared in the study for their effectiveness in preventing shortening of the first ray during joint fusion surgery?
  3. What were the findings of the study regarding the use of an osteotome versus a saw in joint fusion surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about joint fusion is to discuss with your surgeon the method they plan to use during the surgery, particularly if preventing over-shortening is a concern. Ask about the potential benefits and risks of using an osteotome versus a saw, and make sure to follow post-operative care instructions to promote proper healing and recovery.

Suitable For

Patients who are recommended joint fusion surgery typically have severe arthritis in the affected joint, which causes pain, swelling, stiffness, and limited range of motion. Joint fusion is also recommended for patients with foot deformities such as bunions, hammer toes, or flat feet, which can cause significant pain and difficulty walking. Additionally, patients who have not responded to conservative treatments such as medication, physical therapy, or orthotics may be candidates for joint fusion surgery.

Timeline

Before Joint Fusion:

  1. Patient experiences pain and limited mobility in the affected joint.
  2. Patient may try conservative treatments such as medication, physical therapy, or injections.
  3. If conservative treatments fail, patient and healthcare provider may decide on joint fusion surgery as a last resort option.

During Joint Fusion:

  1. Patient undergoes pre-operative evaluations and tests to ensure they are a good candidate for surgery.
  2. Surgical team performs the joint fusion surgery, either using an osteotome or a saw to fuse the joint together.
  3. Patient is monitored closely post-operatively for any complications or issues.

After Joint Fusion:

  1. Patient undergoes a period of recovery and rehabilitation, which may include physical therapy and pain management.
  2. Patient gradually regains strength and mobility in the affected joint as it heals and fuses together.
  3. Patient may experience some limitations in range of motion in the fused joint but should have decreased pain and improved function overall.

What to Ask Your Doctor

  1. What is joint fusion surgery and why is it recommended for my condition?
  2. What are the potential risks and complications associated with joint fusion surgery?
  3. How long is the recovery process and what can I expect in terms of pain and mobility after the surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. How long will the fusion take to fully heal and what activities should I avoid during the healing process?
  6. What are the chances of the joint fusing successfully and what factors can affect the outcome?
  7. Will I need to have any follow-up appointments or X-rays to monitor the fusion?
  8. Is there a difference in outcomes between using an osteotome or a saw during the surgery, and which method do you recommend based on my specific case?
  9. Are there any alternative treatments for my condition besides joint fusion surgery?
  10. What is the long-term prognosis for my joint after fusion surgery?

Reference

Authors: Dahlgren N, Johnson JL, Huntley S, McKissack H, Chinnakkannu K, Naranje S, Shah A. Journal: Foot Ankle Surg. 2020 Aug;26(6):703-707. doi: 10.1016/j.fas.2019.08.016. Epub 2019 Sep 13. PMID: 31548149