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Big Toe Arthritis

How to heal your big toe arthritis, with and without surgery

In a healthy big toe joint, the ends of each bone are covered by a smooth connective tissue called cartilage. Cartilage protects and cushions the bones during movement. Arthritis of the big toe joint (hallux rigidus) commonly occurs because joint cartilage has worn down, leaving bone rubbing on bone. This may result from normal wear-and-tear as we age or because of past trauma. One in 45 people experience this problem and many of our patients come to us with big toe joint pain and limited joint motion. Activities such as walking, running and even standing on your toes become difficult and painful.

Symptoms may include:

  • Big toe joint pain, especially when the joint is moved up and down
  • A bump, similar to a bunion or callus, at the top of the joint that swells and worsens over time
  • Difficulty wearing shoes because of pain and pressure over the joint
  • Eventually even walking becomes difficult, causing limping, pain in other parts of the foot, discomfort in the knee and hip, and weight gain due to decreased exercise

Non-operative treatment options 

Frankel Foot & Ankle will carefully examine your foot to assess how much range of motion your toe has without pain and perform X-rays to identify the presence and location of bone spurs. Treatments may include:

  • A course of anti-inflammatory medications such as ibuprofen
  • Alternating applications of heat and ice 
  • Joint steroid injections
  • Stiff-soled shoes or those that have a broad toe to reduced pressure
  • Activity modifications

If non-operative treatments are unsuccessful, or when pain is moderate to severe then surgery is indicated.

Three surgical options for big toe arthritis

Unlike many other facilities, at Frankel Foot & Ankle we perform many different types of big toe joint reconstruction and restorative procedures that are tailored to each individual patient. Dr. Frankel may recommend one of the following three surgical options:

Fusion of the big toe joint  

Fusion of the big toe joint locks the big toe in proper alignment. When the big toe is locked in place, and without motion, the joint is no longer painful. Patient satisfaction with this approach is high. 

Frankel Foot & Ankle offers the BOSS total big toe joint replacement

If you lead an active lifestyle, fusion of the big toe joint may not meet your needs. Instead, Frankel Foot & Ankle offers an innovative procedure that replaces the worn-out joint with an artificial joint implant that both restores motion and eliminates pain. Although this may not be for everyone, this can be an excellent choice in the right candidate. Here are some factors that the doctor will take into consideration: 

  • Your medical history 
  • Level of bone quality 
  • Diabetes 
  • Previous joint infections 
  • Exact level of activity

Dr. Frankel has successfully performed the BOSS procedure on numerous cases and patients are happy to have their big toe functionality restored.

And we perform Cartiva Cartilage Replacement

Another innovative choice for treatment of osteoarthritis in the big toe joint is Cartiva® SCI Cartilage Replacement. In this 35 minute procedure, Dr. Marc Frankel will replace the damaged cartilage in your big toe with new, synthetic cartilage that behaves much like the natural cartilage in your big toe joint. It is an FDA-approved option that safely and effectively reduces your arthritis pain while also improving your toe’s range of motion.

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