Treatment Options for First Toe Arthritis

In forefoot surgery, a grading system is used that includes 4 different stages of arthritis, from mild to severe. After conservative/non-surgical treatment has failed, various surgical options exist to address pain and functional limitations. In this survey, surgeons where asked to assign their choice of surgical treatment for each stage (Figure 2). The final choice on which procedure is best for each patient is an individual decision that should be discussed in detail with the treating physician, considering factors such as individual joint status, patient expectations, life style, age, surgical history, physical examination, the ability to heal an arthrodesis, or the willingness to undergo a procedure where future surgery might be required.

Figure 2:

Stages and Treatment Options for First Toe Arthritis. Early stage, mild arthritis includes non-surgical management or surgical cheilectomy with removal of the bony bump on the top of the toe. More advanced stages are typically treated with joint replacement or fusion procedures. Based on survey results, the most popular (>50%) treatment choices per grade are shown below.

Procedure and Hospitalization Timelines

Based on surgeon experience, the typical duration of the Toe HemiCAP® and ToeMotion® joint replacement procedure was less than 60 min by 97% and of those, 34% indicated a procedure length of less than 30 minutes. All surgeons indicated that the procedure is performed on an outpatient basis with a hospital stay of less than 24 hours.

Figure 3: Procedure and Hospital Stay Timelines after Toe HemiCAP® and ToeMotion® joint replacement procedures

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