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What is it?
Cheilectomy is a surgical procedure used to treat arthritis in the big toe joint. You can read more about big toe arthritis on the British orthopaedic Foot and Ankle society website.
The big toe joint, also known as the hallux joint, is located at the base of the big toe and is responsible for movement and stability during walking and other activities. Arthritis in this joint can cause pain, stiffness, and limited mobility. Cheilectomy involves removing bone spurs on the back of the toe joint and clearing out of any scar tissue or loose cartilage from the joint to relieve pain and improve joint function. The procedure is performed under general anaesthesia and typically takes about 30 minutes to complete.
What is the recovery like?
The first 2 weeks after surgery:
After surgery, you will be taken to a recovery area where you will be monitored for a few hours before being discharged. You will be given pain medication to manage any discomfort. You would have had local aneasthetic which means the toe will be pain free and numb for the first several hours. You may need to use crutches but these are not essential as you will be able to walk normally on your foot but may need to wear a special sandal that we will provide to you. You should elevate your foot and apply ice as needed to reduce swelling. You will need to keep the dressing on your foot clean and dry, and follow any specific instructions that I will give you on the day.
The next 4 weeks after surgery:
I will see you at 2 weeks post surgery to remove the dressings and check the wound. During the next four weeks, you will gradually increase your activity level and begin physiotherapy to help restore strength and mobility to the affected foot. You may wear your normal shoes if they are comfortable and wide fitting. A pair of trainers for example. You may also need to continue taking pain medication as needed but at this stage often there is minimal pain.
6 weeks on:
At this stage you can resume most activities normally including sports and exercise.
What are the risks of surgery?
As with any surgical procedure, there are risks associated with cheilectomy. These risks include infection, bleeding, nerve damage, and poor wound healing. There is also a risk of developing blood clots in the leg, which can be a serious complication. These risks are fortunately very rare in this operation. Be sure to read my notes here with further information on any complications following surgery. I will discuss these risks with you before the procedure and take steps to minimize the risks, such as prescribing antibiotics to prevent infection and using compression stockings to promote circulation in the legs.
Risk of progression of the arthritis?
It is important to note that this operation is not curing the underlying arthritis. It is a ‘tidying up’ operation that makes the joint more mobile and deals with any bone spurs or cartilage defects. The underlying arthritis may progress in time and the toe can become painful again. In those circumstances you may need further treatment with injections or other types of surgery.
