Our Summary
This research paper discusses two different treatment options for a common type of arthritis that affects the big toe joint. Traditionally, if non-surgical treatments don’t work, a procedure called arthrodesis has been the go-to option. This surgery, which fuses the bones in the joint together, has generally been successful and left patients satisfied. However, some patients would rather not have this procedure. This study is looking at the effectiveness of another surgery option, allogeneic cartilage replacement, in comparison to arthrodesis. Allogeneic cartilage replacement is a procedure where damaged cartilage is replaced with cartilage from a donor.
FAQs
- What is the traditional operative care for arthritis of the first metatarsophalangeal joint when nonoperative care fails?
- What is the role of allogeneic cartilage replacement in the treatment of hallux rigidus?
- Are there patients who prefer to avoid arthrodesis for treating arthritis of the first metatarsophalangeal joint?
Doctor’s Tip
A doctor might tell a patient considering joint fusion that while arthrodesis has been a traditional and effective treatment option for arthritis of the joint, there are alternative options such as allogeneic cartilage replacement that may be considered. It is important for the patient to discuss all available options with their doctor to determine the best treatment plan for their individual needs and goals.
Suitable For
Patients who are typically recommended joint fusion include those with severe arthritis of the first metatarsophalangeal joint, specifically those with hallux rigidus or hallux limitus. These patients may have failed nonoperative treatments and are experiencing significant pain and limitation of motion in the joint. Additionally, patients who have a strong preference to avoid joint fusion may be candidates for alternative procedures such as allogeneic cartilage replacement. Ultimately, the decision to recommend joint fusion will depend on the patient’s individual circumstances and goals for treatment.
Timeline
Before joint fusion:
- Patient experiences pain, stiffness, and limited range of motion in the affected joint
- Patient may have tried nonoperative treatments such as medications, physical therapy, and orthotics without success
- Patient consults with a orthopedic surgeon to discuss surgical options
- Surgeon recommends joint fusion as the gold standard treatment for the patient’s condition
After joint fusion:
- Patient undergoes preoperative testing and preparation for surgery
- Surgery is performed to fuse the joint, removing damaged cartilage and stabilizing the joint
- Patient goes through a period of immobilization and physical therapy to aid in the healing process
- Patient gradually resumes normal activities and experiences improved joint stability and reduced pain
- Patient may need to modify their footwear and activities to accommodate the fused joint
- Long-term follow-up care is provided to monitor the fusion and address any complications that may arise
What to Ask Your Doctor
- What are the potential risks and complications of joint fusion surgery?
- How long is the recovery period after joint fusion surgery?
- Will I be able to resume normal activities and exercise after joint fusion surgery?
- Are there alternative treatments to joint fusion that I should consider?
- How successful is joint fusion surgery in relieving pain and improving joint function?
- Will I need physical therapy after joint fusion surgery?
- How long will the effects of joint fusion surgery last?
- What is the likelihood of needing additional surgery in the future after joint fusion?
- How soon can I expect to see improvement in my symptoms after joint fusion surgery?
- Are there any specific lifestyle changes or precautions I should take after joint fusion surgery to ensure the best possible outcome?
Reference
Authors: Shane A, Reeves C, Wojciechowski R, Smith R. Journal: Clin Podiatr Med Surg. 2025 Jul;42(3):553-562. doi: 10.1016/j.cpm.2025.03.003. Epub 2025 Apr 30. PMID: 40483037