Hallux Rigidus

Hallux Rigidus, also known as big toe arthritis, is a very common orthopaedic problem and is the most common site of arthritis in the foot.

This process happens at the base of the great toe at the metatarsophalangeal joint (MTPJ). It can often happen after an old injury or you may be prone to it due to your family history.

Signs and symptoms include:

  • Pain in the big toe

  • Stiffness

  • Swelling

  • Limited walking distance

  • A lump over your big toe

While initially it can be managed non-operatively, it usually becomes worse over time as it is a degenerative and progressive condition. This is especially true if you are active.

Initial treatments include:

  • Pain relief

  • Shoe wear modification

  • Activity modification

  • Weight loss

  • Steroid injection

If over time these do not prove to be successful there are surgical options available to fix the problem with the gold standard being a fusion procedure.

Big Toe Arthritis Surgery

FAQs

How do I know I have Big Toe Arthritis?

You will notice your big toe becomes stiff and painful. It can swell up and walking becomes difficult in normal shoes or barefoot. An X-ray is useful in diagnosing this condition.

What are the surgeries for Big Toe Arthritis?

Depending of the severity of the disease and your function there are different surgical options.

For milder conditions the joint can be maintained and partial bone removal (cheilectomy) is possible.

In more severe disease, a fusion procedure (1st metatarsophalangeal joint arthrodesis) is very successful at alleviating your pain. In this procedure the diseased arthritic joint is removed and the joint is fused using a plate and screws. While some motion is lost, it doesn’t affect your everyday functionality. There are also joint implant options that can preserve range of motion in the great toe, but these have not been as successful as a fusion procedure.

Janan Chandrananth Orthopaedic Surgeon Big Toe Arthritis Best Post-operative Shoe

How long am I off my feet after Big Toe surgery?

We aim to get you walking day 1. You are fitted with a special post-operative shoe that helps put most of your weight through the heel rather than the front of your foot. You will be in this shoe for about 6 weeks. Depending on the time of your operation you may be able to go home the same day, otherwise you will stay in hospital overnight. You will expect some postoperative pain and swelling, and the pain starts to improve after a day or so. You are advised not to do any heavy lifting or strenuous activities for 6 weeks after which you can gradually return to full duties.