Surgery is usually only considered after more conservative treatment options have been tried, such as avoiding activities that cause problems, wearing special footwear or insoles, and steroid injections.
Surgery may be recommended when the arthritis is severe, when it causes pain and when it affects the patient’s quality of life. When the condition affects both feet, then the foot causing most problems will be operated on first.
The procedure is usually carried out under a local anaesthetic (so you’ll stay awake but you won’t feel anything). It’s a relatively quick operation, and you should be able to go home on the same day although you won’t be able to drive yourself.
A small incision is made on top of the foot at the base of the big toe. Any cartilage remaining between the two bones is cleared away, allowing the two bones to come into contact with each other. The ends of each bone may need to be shaped to achieve a good fit. A metal plate and screws are used to hold the bones together; this is the position in which the two bones will heal together over the coming weeks. After surgery, the incision is closed with stitches.
Immediately after surgery we’ll help you manage any pain or discomfort with painkillers. We’ll discuss your aftercare and arrange any follow-up appointments with you before you leave hospital.
In the next few days you’ll be able to walk with the aid of crutches but you’ll need plenty of rest with your foot raised. You may be given a special shoe to make sure you don’t put too much weight on the wrong part of your foot.
After three to four weeks you should be able to resume normal day to day activities.
As with any surgical procedure there can be some risks, including:
- blood clots (including deep vein thrombosis (DVT)
Specific risks of surgery in the region of the toe include:
- nerve damage, numbness
- bone not healing well
- pain in other parts of the foot (particularly the ball or other toes)
- complex regional pain syndrome (can cause chronic burning pain in one of the limbs)