Fusion of the big toe joint is only indicated when the joint is very painful and so badly damaged that it cannot be repaired or treated without fusion.

The operation is actually quite straight-forward when performed by an experienced surgeon. The damaged joint is exposed and the damaged cartilage is removed. The two pieces of bone are then held together with screws or a plate. It is important that the joint is fixed in a slightly upward position as this helps with walking on the foot. The operation takes no more than about 45 minutes to complete and may be performed with the patient awak or asleep.

No, nowadays for most patients a leg cast is not necessary as the fixation used to hold the bones in place is very strong and the big toe joint fusion should heal without any problems. Patients are provided with crutches and wear a surgical shoe for four to six weeks after surgery.

Fusion of the big toe joint is very successful relieving the pain from the arthritic big toe joint. Successful fusion is seen in over 95% of patients who are healthy and follow the post-operative advice.

Normal walking requires full movement of the big toe joints. However you need to keep in mind that this operation is only indicated when the big toe joint is painful from arthritis. This means the joint is already not moving properly. Although the operation results in a stiff big toe joint most patients find they adapt their walking easily and feel the reduction in the pain from the joint makes up for the loss of the movement.

The alternative treatments very much depend on the amount of joint damage and your health and activity levels. If the joint cartilage is severely damaged then other options may include: # Keller arthroplasty # Joint replacement Mr Metcalfe will discuss in great detail the best options for each patient taking into consideration all the key factors.