If the degree of degenerative change in the joint is mild then an operation called a cheilectomy may be carried out. This involves removing the degenerative bony outgrowths (osteophytes) that form to allow increased movement and stop bony impingement. Occasionally the bone is also cut and realigned to improve the movement further. This surgery is generally done as a day-case.
Following the operation patients should try to rest as much as possible for the first two weeks to allow the swelling to settle and the wound to heal. After this period you may be able to return to work, but full recovery can take up to three months.
The operation should improve the range of movement and pain, but is not guaranteed to work. It will not return the joint to normal as the cartilage on the joint has already been damaged.
Possible Risks or Complications
If the disease is more advanced, or if a cheilectomy has failed, then two other surgical options remain.
The first is an arthrodesis or fusion. This involves removing the cartilage and fusing the two bones together. Although the movement at the base of the toe disappears you will still have movements at the joints on either side. Most people can walk normally without a limp but may be unable to run.
The bones are generally held together by screws, a plate or wires to encourage the bones to fuse. After the operation you will be in a plaster cast or a special shoe for around six weeks. In a small number of patients the bones do not fuse successfully and further surgery may be required.
In a few patients a joint replacement may be carried out rather than a fusion aiming to retain movement at the joint. Not all patients are suitable for this procedure however.