Surgery to Replace the Great Toe Joint
Implant replacement of the first Metatarsophalangeal joint (great toe joint at the ball of the foot) is performed for an arthritic joint, a painful joint, an abnormally stiff joint, or when prior surgery on the joint has failed. The surgery involves removal of the cartilage surfaces of the two bones that make up the joint, and replacing the ends of these bones with an implant system that has stems which are placed into the respective bones. Two total joint implant types are available. One is a single component (a hinge and two stems) made of a silicone polymer, and has been used the longest. The other type includes two separate components made of non-silicone materials (polyethylene and metal). The long term performances of the two component systems is not well documented. There is also the option of a single component implant that replaces only one side of the joint. These implants are made of titanium type materials.
- Attempt to preserve or improve the joint motion.
- Reduce or eliminate pain associated with the joint.
- Reduce or eliminate pain associated with any associated bunion.
- Improve the alignment of the great toe, if required.
- Reduce the prominence of any associated bunion.
Stiffness; Prolonged swelling; Prolonged pain; Delayed healing or non-healing of skin/soft tissue; Circulation disturbance of skin, soft tissue or bone; Infection of soft tissue, implant, or bone; Nerve injury or numbness; Tendon injury or tendonitis; Unsightly or painful scar; Incomplete relief of pain; Malalignment of the great toe (over-correction / Under-correction); Recurrence of toe deformity; Poor toe to ground contact; Shortening of the toe; Weakness of the toe; Callus or pain under adjacent portion of the ball of the foot; Intolerance of the implant (chronic pain, chronic swelling/fibrosis, soft tissue or bone reaction to the implant); Fracture of the bone adjacent to the implant; Implant fatigue failure; Local, distant, or systemic reactions to silicone; Hematoma or bleeding complication; Change in shoe size; Phlebitis; Mild to life threatening reaction to medications and/or anesthesia. You will need to have antibiotics prior to any dental, bowel, or urinary tract procedure.
Usual Post Operative Care/Recovery
Wear a post-operative surgical shoe and use crutches or other assistive device for 2-8 weeks; use elevation rest, water-tight ice packs, and prescribed medications for pain and swelling control; keep bandages and foot dry until sutures are removed in approximately two weeks; Utilize anti-swelling and anti-stiffness physical therapy for one to six months; return to loose shoes or sneakers in approximately 2 to 8 weeks; return to fashionable shoes in one to four months; return to sedentary activities and/or occupation in one to eight weeks; return to demanding activities and/or occupation in one to four months; possible use of orthotics long-term.