Hallux Rigidus: What are my options if I need surgery?

January 18, 2013

rotator cuff pain

HemiCAP Toe DF Implant

Hallux Rigidus is a chronic degeneration of the first toe leading to arthritis of the large joint at the base of the big toe. Pain and stiffness are the main symptoms and are worsening as the degeneration progresses.

In the early stage, stiff soled shoe modification, injections, and pain medication may help; however, mid and end-stage disease may require a surgical procedure to improve the symptoms: Milder forms of Hallux Rigidus can be treated with removal of bone spurs (cheilectomy) to improve your range of motion. More advanced stages of Hallux Rigidus can be treated with joint replacement or, as a procedure of last resort, with a joint fusion leaving your joint permanently stiff.

For many patients, preservation of motion in the big toe is important both from a functional and esthetic perspective. Standing on your toes to reach a high shelf, bending down on the floor, or using fashionable shoes with higher heels all require toe mobility to perform these functions best

partial knee replacement

Every patient is different, but results from over 20,000 HemiCAP Toe implantations have shown that many activities can be enjoyed again.  See some of their success stories here.

Ask your doctor if you may be a candidate for HemiCAP resurfacing or look for a surgeon near you!

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31 responses to “Hallux Rigidus: What are my options if I need surgery?”

  1. Richard Watts says:

    I am four months post surgery with the hemicap procedure in my right big toe. For the most part, the toe seems to be ok, but I am developing pain in the ball of my foot and cannot walk any distance in any type of show w/o pain. Is there PT is should be doing ?

    • Hi Richard, Please let us know where you are located so we can connect you with a Physical Therapist proficient with Arthrosurface post-op protocols. We will also forward your comments to a couple of our key users to see if they can suggest what you should do next.

      Thank you

  2. I had Lapidus surgery and I developed Hallux Ridgidus, w Arthritis in the big toe, ss far as scar release surgery, can it make it worse, what is the worst case scenario, confused on what to do???

  3. Olga voytko says:

    I had a toe joint replacement last June.. I couldn’t get any mobility which my dr felt was scar tissue.. On April 1 of this year he went in and removed the scar tissue and did a couple of other things and it’s still not moving.. My therapist said its like pushing on a brick wall.. I’m thinking now I might have to go in take out the joint and fuse it.. Is that possible!!! I’m in constant pain when I walk,,,

    • arthrosurface says:

      Dear Olga, Could you tell us where you are located? We can then provide a list of surgeons in your area who will be able to answer your questions.

      • Olga voytko says:

        It’s been over a year since my surgery and I am in more pain now than ever.. Both my feet hurt now and I have a big lump on the side of my toe that looks like a bunion.. I can’t feet into many shoes and am very frustrated .. Was actually looking to see if there was a lawsuit against the hemi cap tie joint.. I’ve heard numerous complaints about it.. It has defintely restricted many things that I used to do.. I was always very active and that has changed.. Not very happy about it at all.. My doctor told me in six weeks I would able to wear heels it’s been over a year and I can’t even wear tennis shoes..my doctor was Carl hassleman from upmc three rivers orthopedics..

        • Kathy says:

          I too had the hemicap surgery in Feb 2014 and have exactly the same issues as Olga. I don’t know what to do, I’m in pain with every step, just my right foot which is the hemicap toe.

          • arthrosurface says:

            Hi Kathy – We’re sorry to hear about your discomfort after HemiCAP toe Surgery. We are sending you an email with more information.

    • Timothy Tiarks says:

      I also had a joint replacement approx 1 year ago. I am most likely going to have my toes fused as well due to daily chronic pain in both big toes that have been capped. Not looking foreward to it but see no other option

  4. Monica says:

    I had the total toe replacement four months ago. My ROM seems to be ok for now (the only PT my doctor recommended was wall stretches morning and night) but I still have swelling and distance walking (just one mile) causes increased swelling and much soreness and stiffness afterwards. How long before this goes away?

  5. Matt says:

    Anyone here have a youngswick procedure? ? I have a bone spur, and athritis, along with a chip in the large joint of my big toe … I’m told by my podiatrist that I have hallux rigidus and would need a youngswick procedure … he said clean up od bone spur,chip, and arthritis along with shortening of next bone would be in order to relieve joint and create flexibility. .. any feedback would be appreciated. Thanks

    • JH says:

      Matt, have you had that surgery? What was the outcome?

      • Matt says:

        The short.answer is No, I’ve had no surgery.

        A longer answer …
        1. My doc told me it’s likely best to deal with it as it until I can’t stand it. Basically, if I understand correctly, there is no guarantee with any surgery. Waiting, at least in my case, isn’t going to make new issues elsewhere in my joints. If I experience issues that stem from the toe, I will definitely get the surgery.

        2. Life dealt me a midlife crisis at the end of September. I haven’t been to work since then. I was about to go back in January and ended up breaking both my wrists (left =broken scaphoid, right = broken distal radius)
        Speed the story up and I lost my job from all of this.

        To get to a speedy conclusion

        A. –‘ my job was factory (12 hour shifts on concrete, 90% or more on my feet)
        So, my feet have been given a reprieve in a way.

        B. — I start classes at community college on May 22. I’ll be attending full-time continuously until I have an Associate in Paralegal studies and likely a.computer certificate of.some form.
        So, my feet will hopefully never deal with the continual wear and tear they had to in the past.

        C. I had weighed around 230 when I made the original question. I’m around 195 now and likely will get below 180 when I’m done.
        Less weight = less pain on all lower joints.

        In reality, my feet have been better than thayve.been in at least 5 years.

        Knock on wood.

        If you do have any surgery or experience to share, please do … as I still like to be aware of what I may be in store for.

        Oh … and if it’s of interest the bone spur / chip is in my right foot. .. I actually have a bone spur on the same joint on my left foot as well.
        The right is definitely the worst of the two.

        • Nancy says:

          Hey Matt.
          I’m reading this post in 2018 so not sure if your situation has changed. My Jally rigidus, etc. sounds similar to what you’ve described. Would you be open to speaking offline? I’m nit interested in a replacement or implant but maybe other options. I’m interested in what you ultimately decided to resolve pain issue. Thanks!

  6. Sandy says:

    I had the arthrosurface toe hemicap Implant about two years ago. The swelling never went down and the pain never subsided. Now its to the point I can barely walk on it and it has to be removed. They also have to take a piece of bone from my hip so the my big tbe won’t be really short. I think the fusion would’ve been better. I have a fusion on the other foot and I’ve never had problems with it and it’s been over six years. I know everyone is different but if I had to do it all again I wouldn’t go anywhere near that Arthrosurface implant. My surgery is Monday morning so please say a prayer for me.

    • arthrosurface says:

      We are sorry to hear about your difficult experience. As you know, there are many factors that contribute to a successful outcome and your doctor will be your best resource to help you achieve the optimal outcome. As the medical device manufacturer, Arthrosurface is required to document any customer complaint that alleges deficiencies related to service or the identity, quality, durability, reliability, safety, effectiveness, or performance of the device. Should you believe your case involves any such deficiencies, please contact RA@arthrosurface.com. All customer complaints are reviewed for reporting to FDA

  7. Naomi Stallard says:

    I was told a few years ago that I would benefit from hemicap replacement surgery, but I haven’t done reservat it yet. I still have reservations and questions. If I have this done, will I still be able to wear my pretty shoes? I also am a hospital nurse and wonder how long I’d be out of commission.

  8. Tom says:

    A year ago I had the Hemicap implant proceedure done to my right great toe. Over the past year I tried everything to rehab and alleviate the pain with no success. I got a second option from an orthopedic surgeon who said my best choice was to have the implant removed and fuse the joint. Wrong answer. After researching my opinions I decide on having the Hemicap removed and have a Keller Bunionectomy performed with the use of a cadevar membrane used in the joint for cushioning. My doctor had originally hoped to try to just clean out scar tissue but when he opened me up he found excessive scar tissue and thus decided to do the Keller. Had the surgery yesterday and hopefully we’ll see better results.

    • arthrosurface says:

      We are sorry to hear about your difficult experience. As you know, there are many factors that contribute to a successful outcome and your doctor will be your best resource to help you achieve the optimal outcome. As the medical device manufacturer, Arthrosurface is required to document any customer complaint that alleges deficiencies related to service or the identity, quality, durability, reliability, safety, effectiveness, or performance of the device. Should you believe your case involves any such deficiencies, please contact RA@arthrosurface.com. All customer complaints are reviewed for reporting to FDA

  9. Elizabeth Armstrong says:

    Have a hemi cap in right now. Painful since the day it was put in. Have not been able to work (I am a nurse) since. Saw a new doctor that says he can help me with a TOTAL joint replacement. I am having the surgery but am terrified that my pain level and range of motion will be worse even though he promises he can help me. He comes very well recommended and seems to know what he is doing, he is very confident that he can help me but so did my other foot doctor. Any words of wisdom? I am 55 with zero health complications. I just had a worn out joint from wearing high heels all my life!! I would like to walk pain free, that’s all I want. Can I at least expect this? Or less pain than I have now. My doctor states that I have long toes and the hemi cap leaves my big toe a little short hence my pain. Can a total toe joint replacement help or will it be worse?????

    • arthrosurface says:

      We are sorry to hear about your difficult experience. As you know, there are many factors that contribute to a successful outcome and your doctor will be your best resource to help you achieve the optimal outcome. As the medical device manufacturer, Arthrosurface is required to document any customer complaint that alleges deficiencies related to service or the identity, quality, durability, reliability, safety, effectiveness, or performance of the device. Should you believe your case involves any such deficiencies, please contact RA@arthrosurface.com. All customer complaints are reviewed for reporting to FDA

  10. Elizabeth Armstrong says:

    Am scheduled to have a total toe joint done. I have a hemi cap in presently and am in constant pain. My doctor says he can get me mostly pain free with more ROM. I’m scared it may be worse than what I have now. Any suggestions? People say my doc is great…..

    • Sheri says:

      Elizabeth, can you tell me how your total joint replacement went? I have the same issue as you. My dr recommends a total joint replacement now since I’m having pain in the upper part of my big toe after a partial joint replacement. I am 8 months out from surgery. I’m afraid of more surgery and more drilling out of bone, and what if it still hurts and doesn’t bend? My toes have stiffened up again after undergoing manual manipulation under anesthesia. Very frustrated!

  11. Barb says:

    I have bilateral pain to the hallux of my feet. With what I would describe as a nodule on top of both. The nerve that runs over the top is highly aggravated. Still have mobility, but at the end of the day the pain is terrible. If I were to have it surgically repaired, would I lose mobility completely in that joint. I were high heels most of the time and flats worsen the pain.

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