Toe joint replacement

Overview

Surgery to replace a damaged toe joint with an artificial (man-made) joint is known as toe joint replacement. Metal, ceramic, or plastic are all acceptable materials for the prosthesis, the replacement part. It is designed to function like a typical, healthy toe joint. Toe arthroplasty is another name for toe joint replacement.

The toe joint that requires replacement the most frequently is the metatarsophalangeal (MTP) joint of your big toe. Your big toe and your foot are joined at the first MTP joint. Every time you take a step, the joint must bend. Walking may hurt if your MTP joint is injured or stiff.

Your big toe may also be referred to as hallux, great toe, or first toe.

Reasons for undergoing the procedure

After all other treatments have failed, toe joint replacement can treat specific foot diseases. Options for initial nonsurgical treatment typically include:

• Pain reliever medications.
• Activity changes.
• Injecting steroids.
• Physical therapy.
• Assistive equipment, such as special footwear or a brace to aid with walking.

The following conditions are the most typical causes of toe joint pain:

• Hallux rigidus, or “stiff big toe.”
• Accident, such as a bone fracture.
• Bunions, also known as hallux valgus, are painful protrusions of bone on the outer side of the big toe.
• Rheumatoid arthritis, an inflammatory condition that causes swelling and painful joint
• Osteoarthritis, a condition of the degenerative joints.
• Osteonecrosis, when bone tissue deteriorates from a lack of circulation.

Toe arthroplasty may be beneficial after all other therapeutic approaches have failed:

• Lessen swelling and stiffness
• Reduce joint pain.
• Increase range of motion
• Restore the toe joint’s functionality.

Risks

Complications following toe joint replacement are uncommon but could involve:

• Damage to the nerve
• Clotting of blood
• Wound infection
• Joint or prosthesis infection
• Prosthesis malfunction (it may shatter, become loosened, or dislocate).

Before the procedure

Only an experienced orthopaedic surgeon, ideally one with a foot surgery subspecialty, should perform toe joint replacement. The bone and joint specialist will: before proposing the procedure:

• Inquire about your general health and any existing medical issues.
• Check the toe’s flexibility and strength.
• Describe your toe pain, including how long it has persisted and how it has affected your life.
• Request an X-ray of your foot to see the affected bones in detail.
• Conduct additional exams (such as blood testing) to confirm that you are healthy enough to have surgery.

During the procedure

Toe joint replacement surgery can be carried out either in a hospital setting or at an outpatient surgical center. Two to three hours are typically needed for the surgery.

To put you to sleep, administer anesthetic through an IV in your arm. The surgeon then cuts a small incision on the top of your toe, take out the joint, together with any bone and cartilage damage and inserts the prosthesis. Pins, screws, or bone cement are used to affix it to the bones on either side of your toe joint and makes sure that your artificial joint is properly positioned and fastened. The surgeon then verifies the proper movement of your toe joint. And verifies that all supporting tissues, including tendons and nerves, are in their proper positions. The wound is then stitched to close it and covers your foot and toe with sterile bandages before putting on a cast.

After the procedure

You’ll awaken in a recovery area with your foot wrapped following surgery. Your foot can be covered in a boot or a cast. Your doctor will keep an eye on you to make sure you don’t have any issues or adverse effects from the anesthetic.

You will remain in the recovery area until you can walk safely using an assistive device such as a walker, cane, or crutches. Your doctor will provide you with advice on how to care for your toe before you depart, which may include:

• Applying ice to your toe to relieve discomfort and swelling.
• Lifting your foot as high as you can.
• Going back to get the sutures taken out.
• Wearing shoes with firm, solid soles as frequently as you can.

Outcome

Shortly after the surgery, your surgeon will recommend that you begin walking to start utilizing your new joint. Exercise plays a vital role in your rehabilitation. Initially, walking may be uncomfortable, but it should gradually become less challenging.

Your surgeon may suggest physical therapy as part of your recovery plan following toe joint replacement. Achieving full weight-bearing on your toe may take up to eight weeks.