The surgeon removes damaged cartilage and uses metal plates, screws, or rods to permanently connect the bones. This technique provides stability and pain relief for smaller joints like those in the fingers, wrists, or ankles. The procedure typically involves precise bone preparation to ensure optimal healing.
Joint Fusion & Joint Replacement

Dr Jacqueline Tan
MBBS (SG) | MRCS (Edin) | MMed (Surgery) | FAMS (Hand Surgery)
Joint fusion (arthrodesis) and joint replacement (arthroplasty) are surgical procedures that address severe arthritis when conservative treatments no longer provide adequate relief. Joint fusion permanently connects two bones, eliminating movement to reduce pain, while joint replacement removes damaged joint surfaces and replaces them with artificial components. These procedures restore function and improve quality of life for patients with advanced joint deterioration.



Indications for Surgery
The following conditions may indicate the need for joint fusion or replacement surgery.
- Advanced Arthritis: Severe joint damage from osteoarthritis or rheumatoid arthritis causing persistent pain and limited mobility that affects daily activities.
- Failed Conservative Treatment: Non-surgical treatments, including medications, physical therapy, and lifestyle modifications, no longer provide adequate pain relief.
- Joint Instability: Recurring joint dislocations or severe instability that compromises safety during routine activities.
- Post-traumatic Arthritis: Joint damage resulting from previous injuries that leads to chronic pain and reduced function.
- Joint Deformity: Severe misalignment or deformity that affects normal joint mechanics and causes pain.
Benefits of Surgery
Joint fusion and joint replacement offer several advantages for patients with severe joint conditions. These include:
- Pain Relief: Elimination or significant reduction of chronic joint pain through either complete joint immobilisation or replacement of damaged surfaces.
- Improved Function: Enhanced ability to perform daily activities through either stable fusion or restored joint motion.
- Deformity Correction: Restoration of proper joint alignment and correction of existing deformities.
- Increased Weight-Bearing Capacity: Joint fusion makes the joint more stable, allowing it to bear more weight.
- Long-term Solution: Durable results that can last many years, reducing the need for ongoing conservative treatments.
Surgical Techniques
Traditional Joint Fusion
Minimally Invasive Fusion
This approach uses smaller incisions and specialised instruments to accomplish fusion with less tissue damage. The technique reduces recovery time and post-operative pain while achieving the same fusion results. Surgeons often use fluoroscopic guidance for accurate hardware placement.
Total Joint Replacement
The procedure involves removing damaged joint surfaces and replacing them with metal, plastic, or ceramic components. This technique preserves motion while eliminating pain. The artificial components are designed to replicate natural joint movement and withstand regular use.
Partial Joint Replacement
Only the damaged portion of the joint is replaced, preserving healthy bone and tissue. This technique is particularly suitable for joints where only one section shows significant wear. The procedure often allows for faster recovery and more natural joint mechanics.
Preparing for Surgery
Medical Evaluation
A comprehensive health assessment includes blood tests, imaging studies, and evaluation of overall health status. The surgeon reviews medical history and current medications. Specific tests may be ordered based on individual health conditions.
Medication Adjustments
Certain medications, particularly blood thinners, require modification or temporary discontinuation before surgery. New medications may be prescribed to prepare for surgery.
Pre-operative Testing
Additional tests such as ECG, chest X-rays, or specialised imaging help ensure safety for anaesthesia. The results guide anaesthesia planning and surgical approach. These tests typically occur within 30 days of surgery.
Lifestyle Modifications
Smoking cessation and weight management help optimise surgical outcomes. The surgeon may recommend specific dietary changes or exercise programs. These modifications should begin several weeks before surgery.
Step-by-Step Procedure
Anaesthesia Administration
The anaesthesia team administers either general or regional anaesthesia based on the specific procedure and patient factors. Vital signs are continuously monitored throughout the procedure.
Surgical Approach
The surgeon makes appropriate incisions to access the affected joint. Soft tissues are carefully protected and retracted. The approach varies based on the specific joint and chosen technique.
Joint Preparation
Damaged bone and cartilage are removed using specialised instruments. The surfaces are prepared according to the chosen procedure (fusion or replacement). Precise cuts ensure optimal component positioning or fusion surfaces.
Component Placement/Fusion
For replacements, artificial components are carefully positioned and secured. For fusions, the bones are aligned and fixed with appropriate hardware. The stability of the construct is tested intraoperatively.
Closure
The surgical site is thoroughly cleaned and closed in layers. Drains may be placed if necessary. Sterile dressings are applied, and the joint may be immobilised in a splint or cast.
Are Your Symptoms Affecting Your Quality
of Life?
Consult our MOH-accredited specialist for an accurate diagnosis & personalised treatment plan today.

Post-Surgical Care and Recovery
Immediate Post-operative Care
Pain management begins in the recovery room with appropriate medications. Early mobilisation may begin based on the procedure type.
Hospital Stay
Patients typically remain in hospital for 1-3 days depending on the procedure. Physical therapy begins during this time. The surgeon monitors progress and manages any immediate post-operative needs.
Home Recovery
A detailed home care plan includes wound care, activity restrictions, and exercise protocols. Regular follow-up appointments monitor healing progress. Recovery duration varies from 6-12 weeks depending on the procedure.
Rehabilitation
Structured physical therapy helps restore strength and function. The program advances gradually based on healing progress. Complete recovery may take 3-6 months.
Potential Risks and Complications
Potential risks may include infection, blood clots, nerve or vessel injury, and anaesthesia-related issues. Fusion procedures can sometimes encounter hardware problems, while joint replacements may experience wear, loosening, or dislocation over time. Pain relief may be incomplete, or joint stiffness and delayed healing could occur, occasionally requiring further intervention. Thorough planning and following post-operative care recommendations help minimise these complications.
Frequently Asked Questions
How long do artificial joints last?
Modern joint replacements typically last 15-20 years, though longevity varies based on activity level, body weight, and joint type. Younger, more active patients may require revision surgery later in life.
Can I return to sports after joint fusion or replacement?
Low-impact activities are generally permitted after full recovery. High-impact sports may be restricted, particularly after joint replacement. The surgeon provides specific activity guidelines based on the procedure and individual factors.
What is the success rate of these procedures?
Success rates exceed 90% for both fusion and replacement procedures when performed for appropriate indications. Factors affecting success include patient selection, surgical technique, and compliance with post-operative protocols.

Dr Jacqueline Tan
MBBS (SG)
MRCS (Edin)
MMed (Surgery)
FAMS (Hand Surgery)
Dr. Jacqueline Tan is a hand surgeon in Singapore with over 18 years of experience in managing hand, wrist, and nerve conditions. Formerly the Head of Department of Hand and Reconstructive Microsurgery at Singapore General Hospital, she has continued to contribute significantly to her profession.
- Director of Micro-Reconstruction Service and the Director of Peripheral Nerve and Paralytic Upper Limb Service
- Upon the completion of her training as a hand surgeon in Singapore, Dr Tan was awarded the prestigious Health Manpower Development Plan scholarship by the Ministry of Health (MOH).
- Completed a one-year advanced fellowship in Taiwan under the tutelage of internationally-acclaimed Hand and Orthopedic Microsurgeon – Professor Yuan-Kun Tu
- Dr Tan’s field of expertise is in early and late brachial plexus reconstruction, peripheral nerve disorders, reconstructive microsurgery of the extremities and wrist disorders.
Widely Published
In hand surgery
Active In
Academic Teaching
Billing & Insurance
Our clinic is on the specialist panels of the following Health Networks/Insurance Plans, and we are happy to assist with your claims or attend to any query you may have.











Make An Enquiry
Please leave us a message, and our friendly clinic staff will get back to you promptly.
Mt Elizabeth Novena Hospital
38 Irrawaddy Road #07-42
Singapore 329563
Weekdays: 8:30am – 5:30pm
Saturdays: 8:30am – 12:30pm
Sundays & Public Holidays: Closed