When you have severe osteoarthritis in your foot, you may need a big toe joint fusion to relieve pain and maintain your mobility. Considered a treatment option for late-stage foot arthritis, this surgery, also called “arthrodesis,” can secure your toe and relieve some symptoms of arthritis.  


What is Big Toe Joint Fusion?

Joint fusion—whether in your big toe or in other foot or ankle joints—is a surgical procedure that locks your joint in place. With the big toe, we fuse its joint together, removing any remaining cartilage that was subject to arthritic damage. Following the procedure, most patients experience pain relief, and a return to normal walking. 

Any deformities in the toe or foot are also improved with this surgery. And, best of all, the procedure makes your body think you’ve fractured your toe. This triggers a reaction that allows your big toe to heal as one solid bone, ensuring it remains in a position that optimizes your biomechanics. (That term describes the way your muscles, joints, ligaments and tendons work together to let you move.) 


Big Toe Fusion for Arthritis: Who’s a Candidate? 

This surgery isn’t a first-line treatment for arthritis pain. In fact, when you seek early intervention for osteoarthritis, we can often manage your pain and prevent progression with minimally invasive treatments. Options include over the counter anti-inflammatory medications; injections; movement modifications; or even something as simple as adding custom orthotics to your supportive footwear. 

When these methods don’t offer relief, less invasive surgeries such as bone spur removals may offer sufficient joint pain relief. As such, we consider big toe joint fusion a treatment option to consider when more conservative measures aren’t offering relief. It is meant for patients who have very bad arthritis, specifically in the toe joint, or for patients who’ve had prior surgical treatments but still have joint pain. 

Even then, we only recommend fusion procedures to patients who are healthy enough to withstand and heal from surgery. For this reason, if you have conditions such as diabetes, osteoporosis or peripheral vascular disease, or if you suffer from a Vitamin D deficiency, surgery may not be your best option. In these cases, we’d review all the potential post-surgical complications before scheduling your big toe fusion. 

During Surgery: What to Expect  A foot with a red sore bunion and arthritis

While we perform this procedure in the operating room, using sedation and local anesthetic, you should be able to go home the day of your surgery, avoiding an overnight stay. During the big toe joint fusion, we’ll make a small incision to expose the joint and see how far arthritis has progressed.  Next, we’ll remove all of the inflamed joint lining (called the synovium), along with any remaining cartilage in the area.  Finally, we may stabilize the joint to maintain its position and ensure proper healing. After that, we’ll complete the procedure by suturing your incision site and sterilizing the surrounding skin to prevent infection. 


In total, the procedure lasts for about one to two hours, with surgery length varying depending on your specific disease progression. After you’re fully alert and ready to go home, we will provide you with post-operative instructions that will make sure you have a smooth recovery. 

Recovering from Big Toe Joint Fusion Surgery

After this surgical treatment for arthritis, we may suggest keeping weight off your affected foot for a short period of time. This will help reduce your pain and swelling, while protecting your incision site from disruption or infection.  For most patients, we’ll then transition you to a surgical boot or shoe, allowing you to walk with reduced impact on your big toe. 

Between six and eight weeks later, you’ll come back to the office for x-rays to see how the big toe fusion is healing. About four weeks later, or 12 weeks after your procedure, you will likely be able to resume normal activities. But keep in mind that everyone heals differently, and it’s normal to experience minor discomfort and swelling for several months after your procedure. 

Other Reasons to Seek Big Toe Joint Fusion

This surgery is typically used to treat patients with advanced osteoarthritis of the toe joint.  Yet it may also help patients with Ehrlos-Danlos-Syndrome, a connective tissue disorder that causes so much laxity in your ligaments that bunions offer recur, even after standard correction procedures. In the past, some people with severe bunion deformities chose to undergo big toe fusion. But today, thanks to the less invasive and more effective bunion correction surgery known as lapiplasty, fewer bunion patients need to find relief via fusion surgery. 

Joint Fusion Surgery Risks: What to Watch For

Like any surgical procedure, there are some risks associated with a big toe joint fusion. These include infection, nerve damage, blood clots and a failure of the joint to fuse. However, unless you have an underlying condition such as the ones highlighted above, these risks are relatively low. And, after consulting with our podiatrists in Medford, OR to make sure this is the right treatment option for your arthritis, you’re far more likely to come away from this surgery walking with greater ease, experiencing less pain, and restoring your foot’s pre-arthritic silhouette.  

Big Toe Joint Fusion in Medford, OR

Is late-stage arthritis in your big toe making it difficult to get through the day without pain? Is simply walking to the kitchen for a drink or snack becoming challenging? Choosing big toe fusion surgery may be your best way to relieve your pain and preserve or restore your mobility. 
Not sure if now is the right time to schedule this procedure, or if you’re a good candidate for a big toe fusion? Don’t worry: our experts are here to help. Simply schedule a consultation in our Medford, OR podiatrists’ office, and we’ll discuss all the available treatment options to relieve your arthritis pain. And remember, the sooner you come in to address osteoarthritis, the more likely it is that we can stop the pain and slow disease progression with non-surgical treatment options!

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