Mr John McKinley, Orthopaedic Surgeon

MBChB BMSc(Hons) FRCS(Orth)

Biopro Hemiarthroplasty

Biopro hemiarthroplasty is a type of joint replacement for the first metatarsophalangeal joint in the big toe.  Unlike joint replacements in the hip and knee only one surface of the joint is replaced (this is called a ‘hemiarthroplasty’).

This type of surgery can be carried out if patients have have arthritis in the joint of the big toe; this is known as hallux rigidus.

Traditionally, the aim of surgery for treating this condition has been to fuse the joint, the result of which is that the toe can no longer move, but can no longer cause pain. The aim of more modern approaches to surgical treatment, such as a joint replacement, is to retain movement in the joint while at the same time relieving pain. There are several joint replacements currently in use, but long-term outcomes are not available for most.

The Biopro (also known as Townley) hemiarthroplasty was designed over 50 years ago by a surgeon in America. He operated on nearly 300 arthritic toe joints and followed them up over a period of 40 years. 95% of patients had either a good or excellent result. The implant has now been marketed more widely and been used at the Edinburgh Royal Infirmary since 2006 and has had similar results.

The surgery is generally carried out as a day-case procedure, but requires a general anaesthetic. An incision is made over the top of the toe and the joint is exposed. Any extra bits of bone are removed and a small amount of bone is removed from the joint to allow the implant to be fixed in place. Generally the wounds are closed with a dissolvable stitch and a large bandage applied.

Click here to find out about recovery and possible risks.

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