In cases of moderate and severe hallux rigidus it may be necessary to consider a joint fusion procedure, known as an arthrodesis. This is a joint destructive procedure and involves fixing in place the large joint at the base of your 1^st toe.

While it may sound extreme, it is often the best option for individuals with severe joint pain and functional restriction. The toe is fixed in a position that still allows weight bearing and walking, resolving pain, improving overall function and allowing return to normal activities.

The surgery will involve an incision and surgical fracture (cut) to one or more bones in your foot, allowing the bones to be manipulated and realigned. In an arthrodesis cuts are made at both sides of the 1^st metatarsal-phalangeal joint to prepare the joint to be fused. The two ends are then fixed together stiffly with screws or other fixation devices including surgical plates or wire. A bone graft, synthetic or natural, may be used to ensure there isn’t a significant loss of length following removal of the joint. Prior to fusion, the toe is positioned such that it will remain able to weight bear and allow walking and other activity.

All surgical procedures have advantages and risks that Dr Pocklington (Podiatric Surgeon) will discuss with you in detail prior to your surgery. An arthrodesis generally takes between 30 minutes and an hour to perform. Anaesthetic injections are used to numb your foot locally in all cases, but an anaesthetist will also provide either a general anaesthetic or IV sedation.

An arthrodesis is usually a day procedure allowing you to immediately weight bear on your foot in a stiff sole surgical shoe. Sometimes people stay overnight at a private hospital and return home the following day. A period of semi-weightbearing in a CAM walker or surgical shoe may be required and some patients are more comfortable with the use of crutches immediately after surgery.

Pain relief after surgery usually involves a combination of painkillers and anti-inflammatories, but significant pain relief is often unnecessary. Paracetamol is usually all that is required within the first week.

Bony healing with complete fusion of the joint occurs between 8 to 12 weeks after surgery. Usually restricted activities, including time off work, is necessary for between 6 and 8 weeks. Dressings are removed and replaced at 1 week, giving you an opportunity to see your progress and discuss it with Dr Pocklington (Podiatric Surgeon). Sutures are usually removed at 2 weeks. The process of healing after surgery is important and requires ongoing attention from your surgeon. A podiatric range of motion exercise and stretching rehabilitation program begins immediately to ensure function is returned to the foot, toe and your life as soon as possible.

Please book online to speak with Dr Pocklington (Podiatric Surgeon) about hallux rigidus correction.