Hallux rigidus surgery is used to treat arthritis of the big toe joint when symptoms persist despite non-surgical treatment.
Mr Edward Dawe is a consultant orthopaedic foot and ankle surgeon specialising in the management of hallux rigidus and big toe arthritis. He sees patients in Chichester, Worthing and Haywards Heath.
What is hallux rigidus surgery?
Hallux rigidus surgery includes a range of procedures designed to relieve pain and improve function in the big toe joint. The most appropriate procedure depends on the severity of arthritis, the amount of remaining movement in the joint and individual patient factors.
When is surgery considered?
Surgery may be considered when pain, stiffness or loss of function persists despite non-surgical treatment such as footwear modification, orthotics, activity modification or injections.
Types of hallux rigidus surgery
Several procedures may be used depending on the severity of arthritis.
Cheilectomy
Removal of bone spurs from the big toe joint to improve movement and reduce pain. This is often suitable for earlier stages of arthritis. In most cases, this can be performed using minimally invasive (keyhole) techniques with small incisions and specialised instruments.
Recovery after cheilectomy
Dressings are usually kept in place for around 48 hours
Patients are able to full weight-bear from the day of surgery in a rigid postoperative shoe
Most patients return to normal footwear as comfort allows
Swelling and symptoms settle gradually over the following months
Joint-preserving procedures
In selected patients, joint-preserving procedures can be used to improve symptoms while maintaining movement in the big toe.
These procedures are designed to:
improve joint mechanics
reduce pressure within the joint
increase comfortable range of movement
Examples include procedures such as Moberg osteotomy or modified Youngswick osteotomy. The most appropriate option depends on the pattern and severity of arthritis.
Recovery after joint-preserving surgery
Patients are usually able to weight-bear in a postoperative shoe
Activity is gradually increased over the first few weeks
Swelling and stiffness improve over several months
Fusion of the big toe joint is a reliable surgical option for more advanced arthritis and can provide excellent pain relief when the joint is severely damaged. The procedure involves removing the worn joint surfaces and fixing the bones together, usually with a plate and screws. This stops movement at the arthritic joint and prevents painful contact within the joint. Although the joint itself no longer moves after fusion, most patients are able to return to normal activities. Other joints in the foot compensate for the loss of movement, and many patients are able to walk, exercise and wear normal footwear comfortably.
Recovery after big toe fusion
Surgery is usually performed as a day-case procedure
Patients are able to walk on the foot from the day of surgery in a protective shoe
A postoperative shoe is typically worn for around 6 weeks
Activity is gradually increased after the first 2 weeks
Swelling improves over several months and can continue to settle over time
Big toe joint replacement In selected cases, joint replacement of the big toe may be considered.
Recovery after hallux rigidus surgery
Recovery depends on the procedure performed.
Most procedures allow early weight-bearing in a postoperative shoe
More involved procedures may require a period of protection while the bone heals
Swelling and stiffness can improve gradually over several months
Frequently asked questions
Which operation is best for hallux rigidus? The most appropriate procedure depends on the severity of arthritis, joint movement and individual patient factors. This is discussed during consultation.
Can hallux rigidus be treated without surgery? Many patients can manage symptoms with non-surgical treatments. Surgery is usually considered when symptoms persist.
Will I be able to walk after surgery? Most patients are able to walk immediately in a protective shoe after surgery.