Procedure

Toe Joint Replacement- Orthopedics

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Why toe joint replacement is required?

Big toe stiffness (known as hallux rigidus) is a type of degenerative arthritis that causes pain and stiffness in the metatarsophalangeal joint. The metatarsophalangeal joint is the joint where the big toe (the hallux) joins the foot. Development of arthritis in the toe joint can eventually damage the cartilage and this can lead to pain, swelling, stiffness and eventually can affect motion. When all other conservative treatment fails, toe joint replacement is recommended. It is also recommended if the joint is severely damaged.

Which Doctor to Consult?

Toe joint replacement will be done by an orthopedic surgeon i.e. a surgeonwho specalizes in treating bone and skeletal disorders.

What to expect during the toe joint replacement?

General anaesthesia is used for toe joint replacement.  During the surgery, a small cut is made near big toe joint. After careful examination of the damage to the joint, the surgeon will shave any lumps (bone spurs). Depending on the patient’s situation in order to replace either a small part or entire toe joint, metal or plastic prosthesis (replacement components) is used. The wound would be closed with sutures or staples and will be covered with a sterile dressing. Patient will need to use crutches. Generally, most of the patients can go home the following day.

Post-operative care:

Following post-operative care is necessary:

  • The sterile dressing is left intact until follow-up.
  • Immediate full weight bearing is only allowed in a postoperative shoe.
  • Patients must not put any pressure or full weight on the foot at least till 6-8 weeks until they are advised to do so.
  • Rest and elevate the foot for at least one week and take pain killers to relieve pain as per the doctor’s advice.
  • Sutures or staples are removed approximately 10 to 14 days after surgery.
  • Physical therapy is recommended.
  • Coban wrap is used for swelling reduction.

Complications:

As with any surgery, certain post-operative complications may arise. 

Complications may include:

  • Persistent swelling
  • Wound healing issues
  • Stiffness
  • Bleeding
  • Infection
  • Blood clots
  • Continuous pain
  • Nerve injury (this leads to numbness)
  • Dislocation of the joint
  • No bone growth around the implant

References:

  • https://www.ncbi.nlm.nih.gov/pubmed/?term=27261805
  • https://www.nuffieldhealth.com/treatments/toe-joint-replacement
  • https://my.clevelandclinic.org/health/diseases/14665-hallux-rigidus
  • https://www.methodistphysiciangroupspecialists.org/blog/breakthrough-treatment-for-big-toe-joint-arthritis
About the Author:

Dr. Anand Lakhkar is a physician scientist from India. He completed his basic medical education from India and his postgraduate training in pharmacology from the United States. He has a MS degree in pharmacology from New York Medical College, a MS degree in Cancer/Neuro Pharmacology from Georgetown University and a PhD in Pharmacology from New York Medical College where he was the recipient of the Graduate Faculty Council Award for academic and research excellence.  His research area of expertise is in pulmonary hypertension, traumatic brain injury and cardiovascular pharmacology.  He has multiple publications in international peer-reviewed journals and has presented his research at at prestigious conferences.

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