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Big toe (1st MTP joint) Arthritis

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Orthopaedics 360

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Big Toe Arthritis most commonly affects that base of the toe, at the joint called the 1st Metatarsophalangeal (MTP) joint . It is the most common location for arthritis around the foot and ankle, and is typically seen in adults between the ages of 30 to 60. The resulting stiffness and big toe joint pain often leads to patients seeking specialist review. 

 

Anatomy of the 1st MTP Joint

Mike smith 1st MTP joint
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The 1st MTP joint is the large ‘ball and socket’ joint at the base of the big toe. It’s normal function is to allow considerable movement to assist with a normal gait pattern during the ‘toe off’ phase of walking / running.

When arthritis develops within this joint, it is often referred to as Hallux Rigidus

 

What causes hallux rigidus | Big toe Arthritis?

In many of our patients, there is no specific cause found for the development of arthritis. While it may develop in some individuals following a specific injury (‘Turf toe’ / Fracture), this is not always the case. Gout is one condition that has a predisposition to this joint. Hallux Rigidus may appear in one foot ,or be present in both symmetrically.

 

What symptoms to people experience?

Patients with big toe arthritis (Hallux Rigidus) will typically present with joint pain affecting the base of the big toe. This results in pain that is often exacerbated with walking and running. A visible ‘bump’ if often seen on the side / top of the toe, and this represents a bony spur (osteophyte) that has developed as part of the arthritic process.

toe spur from arthritis mike smith
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The stiffness that develops within the joint can prohibit the wearing of certain shoes, such as those with a heel.

mike smith toe arthritis management
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‘Hallux Rigidus’ | Big Toe Arthritis Treatment

What are your options?

Hallux Rigidus can be present with varying degrees of severity, both in terms of ones symptoms, and the findings on imaging (Xray) There are two board groups of treatment options.

Nonoperative Treatment

Nonoperative options aim to reduce the pain within the joint itself. While not curative of the arthritis, attempts at providing orthotics to relieve the pressure under the joint, or adapting footwear to reduce the movement through the joint, may help alleviate the pain. Other standard analgesic regimens such as paracetamol and anti-inflammatories may also be helpful.

non operative management of hallux rigidus
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Surgical options

There are three main surgical options for big toe arthritis depending on the patients symptoms, severity of arthritic, and level of activity.

 

1. Dorsal Cheilectomy (Spur removal) +/- Joint Debridement

 

2. Joint fusion / arthrodesis

 

3. Hydrogel Cap (CARTIVA) hemiarthroplasty

mike smith toe arthritis management
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‘Big toe’ arthritis management

What’s new on the horizon

CARTIVA

Duel Benefits

Experience pain relief

Improved joint motion

mike smith big toe joint pain
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Ankle sprains and arthritis

People don’t generally tend to associate ankle sprains with ankle arthritis due to its seemingly innocuous presentation in comparison to ankle fractures or dislocations, however recurrent ankle sprains can result in serious trauma to the ankle. Post traumatic...

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Disclaimer: Please note that this is general advice only - for more information, please consult your regular doctor, or obtain a referral to see a specialist orthopaedic surgeon. 

Orthopaedics 360

Orthopaedics 360

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F: (08) 7099 0171

Southern Specialist Centre

Orthopaedics 360

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Health @ Hindmarsh

Orthopaedics 360

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