Big toe joint osteoarthritis - debridement or fusion

SLJBartlet1

I would like to hear from anyone who has experienced this kind of surgical intervention. I have osteoarthritis in my left big toe joint, and only 30-40 per cent movement in it, as it is too painful to move any more. I'm unable to push off with my left foot, and have to wear shoes with rigid soles, or rocker bottoms, in order to avoid bending it.
I'm on the waiting list for surgical intervention which will either involve debridement - removal of any loose cartilage and removal of excess arthritic bone - or fusion. I'm somewhere in between the two, according to my last consultation, and they will probably open it up and make a decision when the time comes, as to which one I have.
Can anyone give me any feedback on either procedure, as to how they got on with it? I need to retain some mobility afterwards as I'm keen to continue some aspect of sporting activity walking/cycling/swimming are my sports. I have given up running.

[Deleted User]

Hello

Welcome to the forum. I am sure you will find support, advice, light relief and friendship here.

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Rebeccarockchick

Hi, I am also hoping someone answers as I too have osteoarthritis in my big left toe.I would be interested in how people have got on with it, if i decide to go ahead with surgery in the future. I saw a surgeon in June to discuss different options. I have quite a large bunion also on my left foot so my choices may vary slightly from yours. How ever the surgeon did say to me he could scrape away the cartilage and remove the wear and tear for now but it will come back so if i have my toe fused then it will be arthritis/pain free forever. "forever" that sounds very tempting! He said to me if the toe joints cannot move they cannot get worn and get more osteoarthritis in them. I cannot bend my toe really very much at all, so i kind of thought it wont make much difference to me if it was stuck forever unable to move it as it has been like that for years anyway. But for someone like yourself who sounds quite a bit more active and sporty than myself surgery like this should never be taken lightly. You should be able to ask the surgeon before hand if after each different procedure offered will you still be able to do walking etc (which I am sure you will be able to do). I would write down all your concerns for your next consultation. Thank you for posting the question...becks

stickywicket

I'm sorry, I can't help. All my foot joints are beyond help as that sort of surgery didn't happen when they first started up.

Unfortunately for you, if people have only the odd joint affected and surgery cures the problem, they tend not to hang about on here. We have one or two regulars who have had ankles and mid foot joints operated on but I can't recall anyone with OA only in their big toe.

It sounds as if your surgeon will do what is best for you while you are in theatre. Our job then is just to make things work. Sometimes that will involve modification of lifestyle but sometimes it can just be a matter of gradually working back to peak fitness.

I hope it goes well.

SLJBartlet1

Thanks to RebeccaRockChick for reply and for contributions by others, so far - all most welcome. Any more, still welcome.
I am told by my consultant that he has other people who have had a toe fusion and can still "Go rock climbing or running". He said it was not as bad as it sounded. I think there is no easy answer. What I do know, is that as an interim measure, to manage the condition, rocker bottom shoes are the best footwear to use. They take away the impact from the ball of the foot, and enable me to walk without too much pain. Expensive but worth it.

dreamdaisy

I'm sorry, I can't help either. I have multiple joints affected by psoriatic and osteo arthritis and any surgery I receive will be joint replacement. It may be worth doing a search on this forum but I am not sure if any relevant will come up. I wish you well with whatever decision you make - please let us know how you get on. DD

TrishaW

I had a fusion of my left big toe in October 2014.
My surgeon made it sound very simple and that I could do sport afterwards (to which I said I hadn't been able to do sport for many years!!!) He said some professional tennis players even play after toe fusion. Anyway I felt quite confident and almost blase about having it done.
The reality has been somewhat different.
I really don't want to put you off as i'm sure it's a great option for many people, but i really hadn't foreseen how it would be for me.
Firstly the surgeon underplayed the post op pain (only very bad for about a week but it was horrendous) and lack of mobility (leg up for 2weeks then weeks of wheelchairs/crutches).
I did everything exactly as told but still had problems.
Unfortunately I got complex regional pain syndrome (CRPS) as a complication of surgery which gave me a purple foot for months, and still gives me nerve pain now.
I then got a delayed fusion so still felt I was walking on a broken toe months later and couldn't return to work.
Even now (10 months post op) I cannot put weight through the toe, wearing rocker bottom trainers, and in worse pain than i was before the op.
Also having a fused toe makes it hard to do certain things such as kneel, get up from the floor etc (though they are difficult anyway) My foot looks good, it just hurts!
My surgeon has suggested revising the operation with a bone graft from my hip, or even just taking out the metal work to see if that's aggrevating things.
I'm afraid in my experience I wish I'd never had this done.
If i had been in complete agony pre-op it may have seemed worth it, but I wasn't in complete agony and could walk better than I can now.
I have been to physio/hydrotherapy every week for 8 months now too.
I think it's hard to take one persons experience though as clearly this operation is a success for some.
I would say -ask lots of questions, and check your surgeons experience (mine was an expert but I was just unlucky). If you have the surgery, apparently taking Vit C in huge doses a few weeks pre op reduces the risk of CRPS. Make sure you see a physio and religiously do the exercises. Eat lots of calcium rich foods and possibly Vit D supplements for bone healing. Buy some thick mens socks to wear over your bandage to keep your feet warm (in a large size) as your toes may be bare otherwise. Get some good pain relief for the first few days (tramadol) and borrow a wheelchair from the Red Cross.
I also wonder whether having a Depo Modrone injection IM for my inflammatory arthritis 6 weeks post op delayed my bone healing....take care with steroids and bone ops!
Good luck with whatever you decide
Trisha

rtempany

Hello, I had both of my big toes fused several years ago and it was the best thing to do for me as I had trouble walking and it was very painfull, I had both toes done at the same time and although I could not walk at all at first I just had to try to and put my feet down and walk a little further each day, it took a while but after a while I was pain free and the only drawback is no more high heels, it is very painfull for the first few days as there is not much around those joints to absorb the pain but well worth the effort, I have now to get my thumbs sorted but I am not keen to do it at the moment, good luck to anyone who is thinking about it. Rita

stickywicket

Hello Rita and welcome to the forum. 'Lindalegs' has a thread on here about her recent thumb op. You might find it useful. I think it was a fusion.