Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Hallux Rigidus surgery and recovery options

Posted by James M on 2/03/03 at 15:32 (107838)

I am a 34 year male with Hallux limitus/ridigus with some flexus. I need surgey and have a couple of options available to me. I live in the UK and the doctor I saw doe not seem to feel implants are ina ny way an option as they are very temporary.

He wants to fuse my joint and I dont want him to. It sounds far too drastic and the range of activities/freedom of movement I might have this surgery seems likley to be very limiting. I dont want to hobble everywhere for the rest of my life. I want to be able to play soccer, squash, walk for miles, jog, etc. I am considering other options such as a cheilectomy, which would preserve the joint and has a shorter recovery time. My doctor feels I would still be in pain even though I would undoubtedly have more movement. Would dietary supplements help to regenerate cartiage and make this oprtaiton an option? e.g. chondroitin/glucosamine/MSM/shark cartilage?

I would like to contact patients who have had either operation to see how it has afftected their lives. This is obviously a major move for me and I want to make the best and most informed decision for my joints.

Cheers
Jim

Re: Hallux Rigidus surgery and recovery options

Dr. Z on 2/03/03 at 19:21 (107856)

Hi,

I perform these types of foot surgery. The fusion is a very good option. However the recovery time is off your feet for 12 weeks with a cast.
I like the implant because there is a quicker recovery. You don't have
to wear a cast or have metal screws or pins inserted inside your foot The biopro metal implant is a very good device that I have used for years with very good results.

These metal implant can last for twenty years. Avoid the silastic implants they aren't as strong. So there are your choices
There are no types of medications that I am aware of that can make the joint surface grow back.
Cheilectomy is a good choice if there is no severe damage to the joint surface.

I hope that this is helpful to you. Good luck

Re: Hallux Rigidus surgery and recovery options

Julie on 2/04/03 at 04:55 (107895)

James

I am in the UK too. If you are thinking of getting a second opinion, and if you're in London or anywhere near, you might like to contact my podiatrist. He is head of podiatric medicine at Guy's & St Thomas's (and also consultant to two football teams, including Charlton, so he knows how athletes feel about retaining their mobility!)

He works in Lewisham and in Harley Street, and operates at Guy's and Blackheath.

His website address, which includes an email contact, is

http://www.londonpodiatry.com

Re: Hallux Rigidus surgery and recovery options

Julie on 2/04/03 at 05:32 (107901)

PS

I know he does bunion surgery, because he told me I should have it. I decided not to, on the advice of the doctors here, who said with one voice 'If it ain't broke, don't fix it' - and it ain't broke: it doesn't look very nice, but gives me no trouble.

Another PS - it occurred to me, as you are only in your 30s, that the 20 years Dr Z says metal pins last really can be considered temporary. I don't know if that was your podiatrist's train of thought?

Re: Hallux Rigidus surgery and recovery options

Ed Davis, DPM on 2/04/03 at 15:30 (107976)

James:

Please take Julie's advice on the second opinion. There are two schools of thought on hallux rigidus, particularly concerning the advisability of fusion.

Fusion can make the big toe joint stop hurting and many may view that as successful treatment. The problem is that gait is altered permanently after fusion of the big toe joint in a manner that can adversely affect one's hip and back.

There is a range of procedures that can be used starting with cheilectomy which is a removal of bone from the top of the first metatarsal head (recently performed succesfull on basketball player Shaq. Oneil), osteotomies that reposition the joint to implants. Some procedures involve combinations of the above.
Ed

Re: Hallux Rigidus surgery and recovery options

Dr. Z on 2/03/03 at 19:21 (107856)

Hi,

I perform these types of foot surgery. The fusion is a very good option. However the recovery time is off your feet for 12 weeks with a cast.
I like the implant because there is a quicker recovery. You don't have
to wear a cast or have metal screws or pins inserted inside your foot The biopro metal implant is a very good device that I have used for years with very good results.

These metal implant can last for twenty years. Avoid the silastic implants they aren't as strong. So there are your choices
There are no types of medications that I am aware of that can make the joint surface grow back.
Cheilectomy is a good choice if there is no severe damage to the joint surface.

I hope that this is helpful to you. Good luck

Re: Hallux Rigidus surgery and recovery options

Julie on 2/04/03 at 04:55 (107895)

James

I am in the UK too. If you are thinking of getting a second opinion, and if you're in London or anywhere near, you might like to contact my podiatrist. He is head of podiatric medicine at Guy's & St Thomas's (and also consultant to two football teams, including Charlton, so he knows how athletes feel about retaining their mobility!)

He works in Lewisham and in Harley Street, and operates at Guy's and Blackheath.

His website address, which includes an email contact, is

http://www.londonpodiatry.com

Re: Hallux Rigidus surgery and recovery options

Julie on 2/04/03 at 05:32 (107901)

PS

I know he does bunion surgery, because he told me I should have it. I decided not to, on the advice of the doctors here, who said with one voice 'If it ain't broke, don't fix it' - and it ain't broke: it doesn't look very nice, but gives me no trouble.

Another PS - it occurred to me, as you are only in your 30s, that the 20 years Dr Z says metal pins last really can be considered temporary. I don't know if that was your podiatrist's train of thought?

Re: Hallux Rigidus surgery and recovery options

Ed Davis, DPM on 2/04/03 at 15:30 (107976)

James:

Please take Julie's advice on the second opinion. There are two schools of thought on hallux rigidus, particularly concerning the advisability of fusion.

Fusion can make the big toe joint stop hurting and many may view that as successful treatment. The problem is that gait is altered permanently after fusion of the big toe joint in a manner that can adversely affect one's hip and back.

There is a range of procedures that can be used starting with cheilectomy which is a removal of bone from the top of the first metatarsal head (recently performed succesfull on basketball player Shaq. Oneil), osteotomies that reposition the joint to implants. Some procedures involve combinations of the above.
Ed

Re: Hallux Rigidus surgery and recovery options

Nervous Nelly on 9/05/06 at 15:07 (209351)

I am scheduled to have the above surgery and I'm very nervous
about the outcome, it is suppose to be a cheilectomy. Is it
possible that when performing this procedure that they might
realize a cheilectomy will not help me after cutting. If
so, will they stop the operation until talking with me. I'm not
sure if I want a fusion or joint replacement.
I'm very active (sports) and want to continue to hike, ski etc.
Also, after the operation what is the percentage that I will
be pain free and will not require any further surgery?
Also, how long do I have to keep off my foot, and will they
put a walking cast on as I will have to work. I understand
there are all kinds of different casts,ie. air cast, etc.
Is this cheilectomy procedure performed frequently. Are there
many infections as a result of this operation. Please advise
any other details concerning this procedure. And lastly, is
there anything else I could do to avoid an operation other
than taking anti-inflammantories and pain killers, which I
don't want to as I have a sensitive stomach.

Thank you,

Nervous Nelly.

Re: Hallux Rigidus surgery and recovery options

Ralph on 9/05/06 at 16:34 (209367)

Hi Nelly,
I'm not a doctor but can certainly understand the nervousness that you say you are experiencing.

Everyone is nervous to some degree when it comes to surgery but if it's overwhelming I'd put the surgery on hold.

I don't know you but sense that maybe part of you is saying don't do it I'm uncertain of things and the other says your in pain get it done.

The questions you posted here are really good ones but I think you should be asking them to the doctor that is going to do your surgery and I wouldn't have the surgery performed until I got the answers.

You also need to find out exactly what your doctors surgical plan is and about your recovery time and follow up that he will be doing. If you are uncomfortable you need to become comfortable before going farther.

You posted 'Is it possible that when performing this procedure that they might realize a cheilectomy will not help me after cutting. If
so, will they stop the operation until talking with me. I'm not
sure if I want a fusion or joint replacement'.

This sounds to me like you've not discussed this yet either. Why wake up with something you don't know you want?

Surgeries are cancelled and put on hold by doctors and patients everyday. Learn about the procedure you are going to have, get all of your 'what if's' answered, make certain you are comfortable with and have faith and trust in your doctor then proceed.

It's better to put things on hold ahead of time then to proceed and regret what was done. You can always reschedule.

What ever you choose to do best of luck to you.

Re: Hallux Rigidus surgery and recovery options

Sue D on 7/24/08 at 09:43 (248667)

I had a cheilectomy 7 months ago but still have very little movement in the joint, and pain on trying to bend it. I have been told to restrict fast walking in the hope that it may recover over the next few months. I am quite disappointed with the result and had hoped to be fully active and pain-free by now. Is this a common result and if no improvement happens, what could be done next?

Re: Hallux Rigidus surgery and recovery options

cs on 8/19/09 at 08:59 (259859)

NEVER schedule surgery if you are not 100% sure. fusion is last resort in my opinion. going with friend for 2nd surgical opinion tomorrow. i was a podiatry specialist (sales) for over 10 yrs.know what you are getting into before you committ. waiting another few wks is not going to change things except if you make a different decision after getting more info! cs

Re: Hallux Rigidus surgery and recovery options

Cindy M on 9/07/09 at 12:46 (260390)

I had a cheilectomy 3 and a half years ago to treat my big toe problems. I was golfing 5 weeks later, walking three miles a couple of times a week, back to 'normal'. It worked for a while but my spurs have grown back. I'm having surgery again in two days (9/9/09) to clean out the joint and putin a titaniumreplacement joint. Hopefully this will solve the problem for longer than just 3-4 years. Doc says I'll 'walk out of the out patient facility' and hopefully be in a wide gym shoe at 4 weeks postop. I think that's how I did it the lasttime, too.

Good luck to you!

Re: Hallux Rigidus surgery and recovery options

Susan on 9/21/09 at 05:21 (260728)

Hello everybody,

My problem is more or less the same as everybody else's, except that four years ago (I am 57) I started dancing, which involves a lot of stepping forwards and backwards, which of course requires plenty of toe flexing - and plenty of pain! I take 150gms of dicolfenac before a dance day and the same on the day itself; I also take 6000gms of chondroitin, glucosamine and MSM daily, which I know definitely helps.

Unfortunately, this regime isn't going to work for much longer as the problem is getting steadily worse and I now have to rest my foot for at least half an hour in the middle of the evening or I can't get through the night (3 hours +). I can only dance once a week as more than that makes my foot extremely inflamed - I have hallux rigidus.

It sounds as if a fusion wouldn't work for me as I wouldn't be able to bend my foot, and anyway, on the days I don't take diclofenac (I only take it for dancing and walking) I have to roll my foot out sideways to walk and it's affecting my knee and hip, so I don't want that anyway, although I realise the day will come when I have to take it every day just to walk. I have considered taking extra pain relief on dance days but I'm not keen on going down that route as I worry about liver damage. Cheilectomy doesn't sound as if it would be suitable either.

So, I was wondering, has anybody got any new information or research on dancers who've had foot surgery?

Living in hope,

Susan