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Metatarsel Joint Replacement

Posted by DaveA on 12/07/00 at 09:02 (034396)

In April 2000, I had a metatarsel joint replacement in my big toe. I have been a runner and an indoor volleyball player. I believe I injured my joint in volleyball but would like to continue running against the advise of my podiatrist. Any suggestions?

Re: Metatarsel Joint Replacement

john h on 12/07/00 at 09:32 (034399)

i looked at this procedure in august of last year and elected to have a chelictomy instead. from all i have read on the subject these implants will not last forever and certainly running would shorten their life. did the doctor offer you any options when you had the surgery? did you have 'any' cartlidge left in the joint? the 1st doctor i saw said i had no cartlidge left and my only option was an artificial joint or fusion. the next two doctors said i had plenty of cartlidge and recommend a chelictomy. fusion is usually the last choice but many people have them and they do stop the pain but i doubt you could ever run again. the toe is usually fused in a slight dorsiflex position. i know a number of ladies who have had the fusion and are very happy with their results. what was you diagnosis?

Re: Metatarsel Joint Replacement

Richard, C.Ped on 12/08/00 at 08:36 (034475)

Hi Dave. I don't usually post on this board since it is about foot surgery, but your post hit home with what I do. I see alot of athletes in my office with conditions such as yours (I also play indoor as well as outdoor volleyball). You may want to look into having custom inserts made with a Morton's Extension. It is a full lenght insert with a 'hard plastic' material that extends under the first metatarsal head to the end of the hallux. We have made them for any condition that requires limited motion of the first MTP joint.

Since it is custom made (if it is made correctly), wearing them would also create a neutral stance which should reduce pressure while walking or running in any specific area and distribute your weight evenly throughout your feet. We have done this for most of the major sports with great success.

Let me know if you think this can help you and if you have any questions. I can also help you find a Certified Pedorthist in your area who can make the insoles for you. You would need a prescription from your physician.

Richard C.Ped

Re: Metatarsel Joint Replacement

Dr. Biehler on 12/08/00 at 10:28 (034488)

The bones the implant goes into have to be hollowed out to recieve the implant. This doesn't leave that much for support if that joint is going to be subjected to high stress. You should have a long talk with your podiatist and discuss the possibility of a bone fracture caused by your sports activity. Dr. B.

Re: Metatarsel Joint Replacement

DaveA on 12/08/00 at 17:51 (034508)

I elected to do the surgery and fusion was not an option because of the belief in the silicone joint recognized by my doctor. According to him, the cartlidge was gone and bone was red-inflamed. I believed it because of the X-ray showing that bone met bone. Even an nurse practioner spotted it.

Re: Metatarsel Joint Replacement

DaveA on 12/08/00 at 17:53 (034509)

I am interested in the foot inserts. Where can I find more information about them? I will review with my podiatrist. By the way, he mentioned that a build up of white, fibrous tissue will build up around the plastic joint. He stated that sometimes even if they break, the patient does not know it. Have you heard of this? Thanks for your response.

Re: Metatarsel Joint Replacement

john h on 12/08/00 at 19:08 (034515)

an orthopedic surgeon aslo advised me to consider shoes with a rollbar to help with the joint condition in the great toe.

Re: Metatarsel Joint Replacement

Dr. Biehler on 12/08/00 at 19:24 (034517)

It is amasing what some of the x-rays look like after the implants have been in for quite a number of years. Some of the x-rays make you wonder how the person could be walking but they do and without pain, Even so, I do not think the implants were made to be put under the stress of high impact sports. Dr. B.

Re: Metatarsel Joint Replacement

john h on 12/07/00 at 09:32 (034399)

i looked at this procedure in august of last year and elected to have a chelictomy instead. from all i have read on the subject these implants will not last forever and certainly running would shorten their life. did the doctor offer you any options when you had the surgery? did you have 'any' cartlidge left in the joint? the 1st doctor i saw said i had no cartlidge left and my only option was an artificial joint or fusion. the next two doctors said i had plenty of cartlidge and recommend a chelictomy. fusion is usually the last choice but many people have them and they do stop the pain but i doubt you could ever run again. the toe is usually fused in a slight dorsiflex position. i know a number of ladies who have had the fusion and are very happy with their results. what was you diagnosis?

Re: Metatarsel Joint Replacement

Richard, C.Ped on 12/08/00 at 08:36 (034475)

Hi Dave. I don't usually post on this board since it is about foot surgery, but your post hit home with what I do. I see alot of athletes in my office with conditions such as yours (I also play indoor as well as outdoor volleyball). You may want to look into having custom inserts made with a Morton's Extension. It is a full lenght insert with a 'hard plastic' material that extends under the first metatarsal head to the end of the hallux. We have made them for any condition that requires limited motion of the first MTP joint.

Since it is custom made (if it is made correctly), wearing them would also create a neutral stance which should reduce pressure while walking or running in any specific area and distribute your weight evenly throughout your feet. We have done this for most of the major sports with great success.

Let me know if you think this can help you and if you have any questions. I can also help you find a Certified Pedorthist in your area who can make the insoles for you. You would need a prescription from your physician.

Richard C.Ped

Re: Metatarsel Joint Replacement

Dr. Biehler on 12/08/00 at 10:28 (034488)

The bones the implant goes into have to be hollowed out to recieve the implant. This doesn't leave that much for support if that joint is going to be subjected to high stress. You should have a long talk with your podiatist and discuss the possibility of a bone fracture caused by your sports activity. Dr. B.

Re: Metatarsel Joint Replacement

DaveA on 12/08/00 at 17:51 (034508)

I elected to do the surgery and fusion was not an option because of the belief in the silicone joint recognized by my doctor. According to him, the cartlidge was gone and bone was red-inflamed. I believed it because of the X-ray showing that bone met bone. Even an nurse practioner spotted it.

Re: Metatarsel Joint Replacement

DaveA on 12/08/00 at 17:53 (034509)

I am interested in the foot inserts. Where can I find more information about them? I will review with my podiatrist. By the way, he mentioned that a build up of white, fibrous tissue will build up around the plastic joint. He stated that sometimes even if they break, the patient does not know it. Have you heard of this? Thanks for your response.

Re: Metatarsel Joint Replacement

john h on 12/08/00 at 19:08 (034515)

an orthopedic surgeon aslo advised me to consider shoes with a rollbar to help with the joint condition in the great toe.

Re: Metatarsel Joint Replacement

Dr. Biehler on 12/08/00 at 19:24 (034517)

It is amasing what some of the x-rays look like after the implants have been in for quite a number of years. Some of the x-rays make you wonder how the person could be walking but they do and without pain, Even so, I do not think the implants were made to be put under the stress of high impact sports. Dr. B.