Foot Surgery: Degenerative Joint Disease

Degenerative joint disease (arthritis) often happens in the joint where the big toe meets the foot. Arthritis breaks down the cartilage that covers the ends of the bones, so the bones can rub against each other. As arthritis gets worse, bone growths (bone spurs) can form, and may cause pain and stiffness in the joint. Your treatment choices depend on how damaged your joint is. There are several nonsurgical treatments. But if these are not helpful, surgery may be considered.

Arthritis may cause one or more bone spurs on the top of the joint. The procedure involves removing bone spurs, often with a small part of the top of the joint itself. You will need to wear a surgical shoe for a few weeks. Once the foot heals, joint movement can be restored.

In fusion, the cartilage and some bone on both sides of the joint are removed. Then, the big toe and metatarsal bones are held together with staples, screws, or a plate and screws. Your foot may be placed in a cast, shoe, or boot. While you heal, you will be asked not to bear weight on this foot. You may also need crutches for several weeks. Because the joint has been removed, your toe will be less flexible.

During surgery, bone growth and arthritis are trimmed, and part of the joint is removed. Soft tissues are fastened in place to support the toe. A pin can be used to align the bones and to keep them from touching. If a pin is used, it is removed after several weeks. Over time, scar tissue may fill in the space where bone was removed. In some cases, the entire joint or part of the joint may be replaced with an implant. You may have to wear a splint or a surgical shoe for several weeks.