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Hallux Rigidus: Wait another Year for Cheilectomy or Cartiva Implant

Posted , 10 users are following.

Garet
Garet

48 years old. I've got Stage II to Stage III hallux rigidus in both big toes, but it's worse in the left.  I tape my toes and which provides support and relieves some of the discomfort when walking long distances, but I slightly roll my feet outward when i walk to avoid the pressure on the big toes.. 

Recently I learnt about Cartiva implant, but it's not available in Asia (I'm an expat working in Asia) therefore I have to wait until I have leave next June.

I'm okay to wait until next June and keep taping the toes, but I'm concerned that it will get worse in that time. I could get a cheilectomy here in the meantime but would rather wait and just have one surgery.

Is waiting another year the wrong choice? If there's anyone with a similar experience, would love to hear from you.

 

1 like, 13 replies

13 Replies

  • patti27250
    patti27250 Garet

    Posted

    Garet, I had the cartiva implant June 28th in Florida and do not regret it at all.  I've had no other surgery for this condition.  So far the pain has been reduced significantly and I have motion back in my joint.  While it isn't perfect I am expecting it to improve even more with time and exercise.  While everyone and every situation is different my only advice is to research online and speak with your doctor.  Maybe you could reach out to a physician in the US and ask them for an opinion.  In the mean time, I am happy to share my experience with you if you have any other questions.

    • Garet
      Garet patti27250

      Posted

      Hi Patti, Thanks for your feedback. I do think I will get the cartiva implant as I already know that I'm a suitable candidate. The only problem is I'll have to wait until next June until I'm back in North America to do it. Right now I'm living in Asia and it's not offered in Asia at this time.

      I just hope my hallux won't progress too much during the next year.

    • patti27250
      patti27250 Garet

      Posted

      Garet, What does the doctor say about having the cheilectomy first and the Cartiva at a later date?  If the pain is more than you can stand maybe that is an option.  Otherwise I don't see that you have much of a choice. I read that the cheilectomy is an option when the damage is mild to moderate.  Advanced stages of hallux rigidus, when the joint damage is severe are often treated by fusing the big toe (arthrodesis). In this procedure, the damaged cartilage is removed and the two bones are fixed together with screws and/or plates to allow for them to grow together. The main advantage of this procedure is that it is a permanent correction with elimination of the arthritis and pain. The major disadvantage is the restriction of movement of the big toe.  I chose to skip the cheilectomy and against the arthrodesus and had the implant.  My doctor says I can always go back and have the arthrodesus later if all else fails.  

      It sounds like you are worried that the pain will become intolerable.  What does your doctor say about taking some NSAIDS or pain meds.  Before my surgery a good shoe with lots of cushion under my toe along with occasional pain medication seemed to help.  

      Good luck to you.  If you need someone to talk to I am here.

      I'll be sending 

      I wish you 

       

  • nancy0814
    nancy0814 Garet

    Posted

    My doctor says its better to leave the bone intact for the implant to take properly when you finally get it done.  He wouldn't remove arthritis or bone spurs when he did the implant. I have been walking on the outside edge of my shoes for ten years and finally had cartiva right toe a week ago.  You will be fine to wait til next June. Just find a doctor that can do both feet at once if you need it. 

    • nancy0814
      nancy0814

      Posted

      I forgot to mention I did go for big toe cortisone injections every three months and this did help me get thru three years of pain before I got the implant.  My doctor did not recommend the cheilectomy surgery.  Said the success rate is very low.
    • Garet
      Garet nancy0814

      Posted

      Hi Nancy

      How is the recovery going now that it's been more than 2 months since your surgery? I am considering getting both feet done in June if I can afford it. The only problem in the meantime is that now the smaller joints on the big toe (the DIP - distal interphalangeal joints) now have bone spurs as well. This may be a result of taping the hallux joint which transferred the pressure to the smaller joints. I guess I'll need those joints fixed too.

      Considering injections if the pain doesn't subside to get me by until June. Already gave up running , cut daily steps from 10,000 to 5,000 and most exercise except for stationary bike.

      Thanks

    • nancy0814
      nancy0814 Garet

      Posted

      I feel normal again. 8 weeks post op. Very little pain. I can run. Do anything I want. I wore steel plates in my shoes pre op. It helped to keep my toe from bending much. Google it. Mortons extensions. I also did cortisone injections,  with X-ray guidance,  right in the ortho office for 10 yrs.,  you need to look into that to get you thru til June.  I have to tell you if you have your bone spurs removed it will be a harder recovery. All I did was get the implant nothing else. That's how I had a quick recovery. 

    • Garet
      Garet nancy0814

      Posted

      Very good to hear that. I'll be getting mine in June. Just have to hold on until then.

      I never got a Morton's extension, but I have happy feet insoles which help a little. The last podiatrist I went to in New Mexico just said to wear comfortable shoes and didn't advise any other modifications which surprised me. I might just have to order a pair online.

      Thanks

    • nancy0814
      nancy0814 Garet

      Posted

      I use happy feet on top of the metal plates. I even wear the metal plates now when I walk and jog to protect the toe until it is fully healed which is about five months, I had to hsve a doctor prescription for the Mortons extension. And went to this special orthopedic store to get them. 
    • Prismonic
      Prismonic nancy0814

      Posted

      Isn't it the bone overgrowth (spurs etc) that causes limitation? What good does the joint replacement without removing the extra bone? Confused.

  • shelley01203
    shelley01203 Garet

    Edited

    Hi there. A cheilectomy may disqualify you as a candidate for the cartiva as there may not be enough bone left for the implant. This was my experience. Plus the cheilectomy made a minor problem a much much bigger one. I am going back for surgery in a few days with a new surgeon. If there is enough bone and he feels there is a good chance the cartiva will work, he is going to try it (due to my preference). It will be more risky given the prior surgery.  If the bone is too thin he will fuse it. I really regret the cheilectomy. After my first surgery I had a "best doctors" review. A top expert from the states pointed out that the biggest clinical study on cartiva did not include patients with prior cheilectomy.  So something to consider. Good luck!

  • vicki125
    vicki125 Garet

    Posted

    Can you please share what Dr you went to in Florida?
  • Gerry1234
    Gerry1234 Garet

    Posted

    If I had to do it again I would have had the fusion. Four months past surgery and still in pain.
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