The Center for Podiatric Care and Sports Medicine

Replacement Player: Toe Joint Replacement

Posted by on Friday, June 22nd, 2012

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Some things are irreplaceable: that ring your first love gave you that disappeared during one of your moves; the original Star Wars toy your mom threw out that’s now worth thousands of dollars; that album of pre-digital family photos; your hair (no, seriously, don’t try the replacements–they look bad. Really bad.).

You know what is replaceable, though? That stiff, painful toe joint that’s been making walking difficult. Yes, although many people are aware that knees and hips can be replaced with artificial versions, not many people know that big toe joint replacement surgery can also be done.

Here’s some information about toe replacements!

Why would I need my big toe joint replaced? Are we not getting along? Well, in some sense, yes–your big toe’s ability to flex up and push down plays a big part in pushing off the ground so you can walk. Normal range of motion is about 50-90 degrees. A loss of 25-30 degrees is referred to as hallux limitus. An almost complete loss of motion is referred to as hallux rigidus.

When the big toe becomes rigid, walking can become an ordeal. If you walk while trying to protect a painful or stiff big toe, you also risk developing other injuries such as back strain and bursitis.

What causes my big toe to become rigid? The most common answers are genetics or overuse that leads to arthritis. This is when the cartilage that provides cushioning between your joints and bones wears out, leaving the bones to rub together and cause painful inflammation. The overstimulated bones may also form bone spurs, or bony outgrowths, that add to the pain and stiffness. The big toe can also become stiff from gout.

How do I end up needing my toe joint replaced? If the cause is gout, then you should be able to solve the problem with diet and lifestyle changes rather than surgery. If it’s arthritis, you can try to deal with a bad big toe joint by wearing shoes with a roomy toe box or orthotics that take some of the pressure off the toe. Eating certain foods can help reduce the inflammation of arthritis which can relieve pain to some degree. In most cases, though, a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) will recommend toe joint replacement surgery.

What happens during the surgery? Your podiatric surgeon shaves off any bony outgrowths and then simply puts in an implant, usually made of nickel or titanium, that will give your toe more range of motion again. Sometimes the implant will only go on one side of the toe; in other cases, both sides may need to be replaced.

Are there any complications? Just the usual surgical risks like infection. Some people experience a lot of pain post-surgery, but that will reside. Other than that the biggest problem is that the artificial joint, like the original, may wear out over time.

What’s recovery like? It varies according to the implant, but in most cases, you would need to keep weight off that foot for six to eight weeks; think crutches or a walking boot. After that, you’ll have one to two months of rehab to help recover the range of motion in your toe. It will take time for the full range of motion to come back, sometimes, almost a year. Still, that beats limping around with a stiff toe.

Agreed.

If you’re having problems with a stiff toe and want to find out if you need toe joint replacement surgery, or if you’re having any other foot issue, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.