Hallux rigidus has traditionally been treated by, first off, conservative measures using anti-inflammatory medications, sometimes stiffening up the bottom of the shoe by placing a carbon fiber plate or some type of a steel shank in the shoe so that you don't bend as much into the joint, so you don't get the pain when you bend. Typically, those only last for a certain period of time until the patient requires something else more invasive, such as an interarticular injection of corticosteroid medication. Once things like that start to fail, then we start to have decisions being made about possible surgical methods of repair. Typically, patients start out having just the top portion of the joint removed because that's where the arthritis typically starts. That procedure's called a dorsal cheilectomy.
Once the patient reaches a point in their arthritic condition where it has involved the entire joint and they have pain with any range of motion attempts at all, then we typically will go ahead and perform a joint fusion, also called an arthrodesis, where we actually remove the joint altogether. We use plates and screws to hold it together until the bones heal across to each other. The joint is completely taken out at that point and your pain is removed because the joint is no longer there.
It's a very good pain relief operation for patients. However, it does take away the motion in the joint and patients do not like that. They want to be able to run and jump and do other activities.
