Hallux rigidus is stiffness and limited movement in the big toe joint due to cartilage degeneration. If not treated, this condition can progress and lead to more serious issues.
Our big toe, the unsung hero of our daily steps, plays a critical role in our everyday movements. However, a problem in this joint can even make a simple walk challenging. Hallux rigidus is stiffness and limited movement in the big toe joint due to cartilage degeneration. If not treated, this condition can progress and lead to more serious issues. So, what is hallux rigidus, what are its stages, and how can it be resolved through surgical interventions?
Hallux rigidus is a form of osteoarthritis that causes limited movement in the big toe joint (metatarsophalangeal joint). The big toe becomes unable to move upwards, leading to pain and discomfort in daily activities.
Hallux rigidus is generally evaluated in four stages. Symptoms and the surgical treatment methods that can be applied vary in each stage:
• Symptoms: Mild limitation in joint movement and pain. Cartilage damage is limited.
• Surgical Treatment:
• Metatarsal Corrective Osteotomies: Surgeries performed to correct the angles of the metatarsal bone to reduce pressure on the big toe. This can help alleviate symptoms by preserving mobility, especially in the early stages.
• Debridement (Joint Cleaning): Removal of osteophytes (bone spurs) and inflamed tissues.
• Symptoms: Increased limitation in movement and pain. Cartilage damage has progressed.
• Surgical Treatment:
• Osteotomies: Corrective procedures on the metatarsal or phalanx bones to reduce pressure on the big toe.
• Arthroplasty Methods: Interventions aimed at reducing pain by preserving mobility.
• Symptoms: Severe limitation in movement. Severe cartilage loss and pain in the joint.
• Surgical Treatment:
• Arthrodesis (Joint Fusion): Fixing the joint completely to eliminate pain. This method generally yields good results in patients and eases daily life activities.
• Resection Arthroplasty: A surgical method aiming to increase the movement of the big toe by removing damaged parts in the joint, but it is generally suitable for specific patient groups.
• Symptoms: Joint is completely immobile. Big toe deformity is severe and there is severe pain.
• Surgical Treatment:
• Arthrodesis: Considered the gold standard treatment at this stage. The joint is completely stabilized, and the pain is relieved.
• Joint Prosthesis: Joint replacement may be considered in severe osteoarthritis cases, but it is known that prostheses do not yield satisfactory long-term results. Joint prosthesis is generally not recommended, especially for young and active patients.
Conservative methods that can be preferred before surgery are also available at each stage:
• Change in footwear and use of appropriate orthotics.
• Anti-inflammatory drugs and physical therapy.
• Corticosteroid injections.
Depending on the stage of the condition, different surgical options may be considered in the treatment of hallux rigidus:
• Cheilectomy: Aimed at increasing the range of motion by removing bone spurs on the joint in early and moderate stages.
• Interpositional Arthroplasty: Applied in cases where cartilage loss in the joint has progressed but where a prosthesis or arthrodesis is not required. Soft tissue is placed to increase the joint space.
Hallux rigidus is a condition that can be successfully treated when intervened at the right time. In the treatment process, the choice of surgical methods is shaped according to the stage of the disease, the patient's lifestyle, and needs. Early diagnosis and getting an expert opinion for your big toe health are key to improving your quality of life.
Remember, every step is a new beginning. Start taking healthy steps today!
