It is osteoarthritis (= progressive wear of the cartilage) of the big toe joint. It may or may not be associated with a deformity of the big toe.
Hallux rigidus can be painless for a long time, there is a progressive stiffening of the joint and the formation of ossifications around the big toe. The pain can evolve by inflammatory outbreaks or also be due to the friction of the ossifications in the shoes.
Before surgery, treatment is limited to adapting the footwear to avoid pain associated with friction. Infiltrations can be carried out at the beginning stage to stop the inflammatory outbreaks. Surgical treatment is indicated if symptoms persist and a distinction is made between conservative treatment (= the joint is preserved) and non-conservative treatment (= the joint is not preserved).
Surgical procedures and techniques
In conservative treatment, painful ossifications are removed to reduce the discomfort associated with friction and other actions can be taken to maintain the mobility of the joint. In non-conservative treatment, the ossifications are also removed and the big toe joint is either blocked (= arthrodesis) or replaced by a prosthesis. The choice between the different surgical treatments is made by the surgeon according to the examination, the x-rays and after discussion with the patient.
It all depends on the gesture performed, in some cases resumption of walking with flexible shoes and early mobilization is recommended to avoid stiffening of the joint. In other cases (arthrodesis) it is necessary to resume walking on a rigid medical shoe (the time for bone consolidation).
frequently asked Questions
Can we walk normally with arthrodesis of the big toe?
YES: The goal of arthrodesis of the big toe is to block a painful and often stiff joint due to osteoarthritis. There is no specific fit after arthrodesis, the goal is to regain normal fit. You can walk normally and even run with arthrodesis of the big toe.
What are the risks when operating a hallux rigidus?
The main risk when operating a hallux rigidus, in particular to remove painful ossifications, is to have a stiffness of the joint sometimes requiring rehabilitation and delaying the resumption of normal walking. It is also possible that the conservative surgery will not completely relieve the pain of osteoarthritis that progresses on its own. In the event of arthrodesis, the main disadvantage is linked to bone consolidation which can sometimes take 3 months to appear and therefore require the wearing of specific shoes until everything is solid and painless.