1st MTP Arthritis

1st MTP Arthritis (Hallux Rigidus)

  • Hallux rigidus is a degenerative joint condition affecting the first metatarso-phalangeal joint
  • Characterized by a painful and stiff joint.
  • Most common form of arthritis in the foot
  • Pathophysiology is believed to be multi-factorial

Surgical Procedures:

Cheilectomy:

open surgical technique used to debride dorsal osteophyte and decrease extension related pain

Cartiva Arthroplasty :

open surgical technique involving implanting a polyvinyl implant into the metarsal head. Decreases pain and preserves motion

1st mtp arthrodesis (fusion):

open surgical technique using plates and screws to eliminate 1st mtp motion. Decreases pain but eliminates motion

Hallux Rigidus
Post Operative Instructions

Cast:

Cheilectomy/Cartiva:

  • you will have a dressing on your foot and be walking in a bunion show for 6 weeks post op
  • At 6 weeks, you will wean off the boot and begin walking in a regular shoe

1st MTP fusion:

  • You will have a plaster cast on your leg for 2 weeks following surgery
  • A walking boot will be worn from 2 to 6 weeks
  • At 6 weeks, you will wean off the boot and begin walking in a regular shoe

Wound:

  • The surgical incision has been closed with sutures
  • Do not get the cast or wound wet for the first two weeks. When showering place a bag over the cast and secure with tape to your leg to avoid the cast and wound getting wet
  • Stitches will be removed at your 2 week appointment
  • After the stitches are removed, you may begin to shower after 2-3 days
  • Do not immerse the foot in water (bath, hot tub, pool) for 4 weeks
  • Do not apply any lotions or creams on the wound for 6 weeks

Weight Bearing:

Cheilectomy/Cartiva

  • You will be walking full weightbeariong in a bunion shoe immediately following surgery

1st MTP fusion:

  • You may walk on your heel only for the first 6 weeks while in a walking boot. You will be given crutches if needed
  • After 6 weeks you may begin fully walking on the foot

Medications:

  • Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol

Driving:

  • For right foot surgery you are not permitted to drive until you have completely weaned off the aircast
  • For left foot surgery, please contact your insurance company to see if you are permitted to drive
  • Driving is not permitted while on narcotics

Work:

  • You will be in a dressing or cast for the first two weeks following surgery

1st MTP fusion

  • You will be permitted to put weight through your heel only. If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery
  • Return to full duties is usually possible after 8-12 weeks

Follow Up:

  • You will have your first appointment 2 weeks after surgery in the Fracture Clinic
  • Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
  • You will have x-rays taken at these appointments

Recovery:

  • It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
  • Please come to the emergency department if you are suffering from severe pain
  • You will get back to most of your activities by 3 months
  • Swelling often remains for 6-12 months
  • You are expected to experience a FULL recovery (no pain, no swelling, ability to walk, etc.) in 9-12 months

Physiotherapy: