Hallux Rigidus final solution

[Blue Streak]

Back on the old EpicSki, Bob posted a thread on his experience with Hallux Rigidus and Dr. Clanton at Steadman. Instead of electing to undertake arthrodesis, I had a cheilectomy in 2014, which was an abject failure.
Since then, I waited for new medical developments, and in fact a new implant called Cartiva was FDA approved.
Notwithstanding the hype, there were many reports of failures of the new device. In fact my own sister had a failed Cartiva implant.
So finally, after dealing with Hallux Rigidus for decades I bit the bullet on August 1 and authorized 1st MTP arthrodesis (big toe joint fusion).
For those of you dealing with the same problem, and wondering what to expect, I will post periodic updates.

The surgery began with conical reaming to prepare the joint.


My doc is a proponent of early weight-bearing, so I hope to be in a walking boot soon.
The first 2-3 weeks are non-weight bearing, with elevating and icing continuously.

After 1 week the foot looked about as good as it could.

On the inside, the hardware is elegantly attached. ( I also had osteotomies of the second and third metatarsals).

 

[mdf]

Good luck!
Lots of stuff going on -- I had to google a lot to understand this thread.

 

[crgildart]

Why the plates and rod on the other toe? Been curious about this because I've had that messed up feeling and periodic pain in my right big toe for about 5 years now. Used to just be a matter of cracking the toe knuckle, but now that doesn't work anymore. Usually only annoying in a minor way unless I land funny on my right foot. When I do it's days of pain higher than the normal somewhat numb feeling.

Anyway, was your other toe with the plate also injured or is that typical for treating the big to to just imobilize both?

 

[Blue Streak]

The osteotomies on 2 and 3 were to deal with transfer metatarsalgia, caused by the Hallux Rigidus.
Look up Weil osteotomy.
Pain in the great toe affects the gait, and weight on the lesser metatarsals causes all kinds of problems.
I could have lived with the Hallux Rigidus, but the pain it caused in the 2nd MTP joint was at times unbearable.
See plantar plate ligament.

 

[Blue Streak]

Warning: graphic
Not my foot

 

[SBrown]

The osteotomies on 2 and 3 were to deal with transfer metatarsalgia, caused by the Hallux Rigidus.
Look up Weil osteotomy.
Pain in the great toe affects the gait, and weight on the lesser metatarsals causes all kinds of problems.
I could have lived with the Hallux Rigidus, but the pain it caused in the 2nd MTP joint was at times unbearable.
See plantar plate ligament.

That issue with the second toe is basically why I have quit tennis. Thanks for posting! Good job waiting, I did a fusion 6 yr ago to fix the replacement I had 12 (?) yr ago, and things have started hurting again. But I can't do anything else now. If my left foot gets bad, it's nice to know there is another option. I don't think this thread will approach the epic epicski thread but who knows.

 

[Blue Streak]

My doc tells me I’ll be able to play tennis again.
I hope I can find my Dunlop Maxply

 

[Blue Streak]

Day 14
Stitches out

One more week non-weight-bearing.
Received a walking boot, which is indeed more comfortable than the fiberglass splint, but I can’t start using it for a week.

The KneeRover will have to be my friend for another couple of weeks. Fortunately it comes equipped with a bar.

The pain was getting manageable, until the doc adjusted the pin in my second toe with a pair of pliers. A couple of extra strength Tylenol should do the trick.

 

[Blue Streak]

Wrong.
Beginning to think I should have tried the Cartiva implant.
It’s hard to say whether the pain is worse from the 1st MTP arthrodesis or the two osteotomies.
I can’t believe it’s only day 16.
Going in today to get a new splint, because the one placed post-op creates a pressure point, resulting in a painful sore. Ah, if only a simple epsom salt soak were permissible! But no.
Knees are taking a beating from using the KneeRover and crawling up the stairs.
Lots of unintended and unanticipated consequences of the surgery.
Not whining-just saying.
Rehab from Cartiva May be much faster, but this is supposed to be a permanent and satisfactory solution. We’ll see.
@SBrown, is your pain in the fused joint?
My doc did mention the remote possibility of hardware removal at a later date, if necessary, which doesn’t sound like much fun.

 

[luliski]

I had foot surgery last summer and the recovery was miserable. I had pins in all of my toes. Hang in there!

 

[Blue Streak]

I had foot surgery last summer and the recovery was miserable. I had pins in all of my toes. Hang in there!

Ouch!

 

[Tricia]

Heal well, man.
We missed you when we were in Colorado this past season.

 

[Blue Streak]

Thanks so much.
This year will be different

 

[Tricia]

Thanks so much.
This year will be different

Different in a good way!

 

[Blue Streak]

Day 21
Begin transition to weight bearing in a walking boot.
Walking with crutches, allowing 25% weight bearing in a boot.

 

[Ron]

New name... Frankenfoot....

 

[Jenny]

Day 21
Begin transition to weight bearing in a walking boot.
Walking with crutches, allowing 25% weight bearing in a boot.

It's such a freeing feeling, isn't it? Congrats!

New name... Frankenfoot....

LOL, that's what I called mine last year after the ankle surgery, too.

 

[Blue Streak]

It's such a freeing feeling, isn't it? Congrats!

OMG!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Such liberation! Just being able to put 25% of my weight on the foot is soooooooooo wonderful!
I think I am right on schedule
At this rate, I could be skiing by Christmas

 

[Blue Streak]

Next milestone is in a week (28 days), when I get that awful pin out.

Then I will be able to take a shower without wearing this thing.

For those of you considering 1st MTP fusion, this is a synopsis of my experience. Yours may be different. But so far, my progress has followed very closely to my expectations.

 

[Jenny]

The pin gives me the creeps. Especially when you mentioned that they twisted it or moved it or whatever - I actually shuddered.

It was this time last year that I went from cast off to partial weight bearing to full weight bearing. Sheer heaven!