1st Metatarsophalangeal arthrodesis, or Big Toe Fusion is the ‘gold standard’ procedure for moderate to severe arthritis.
It provides a pain free, stable toe that allows normal walking. The remaining cartilage in the joint is removed, the bones on either side of the joint are fused together and held with screws and a plate. 90-95% of patients will experience good pain relief. As the majority of patients have a very stiff toe prior to surgery, post operative satisfaction is usually high, with satisfaction with walking and most activities. However, it limits the wearing of high heels and makes running difficult.
Post Operatively patients elevate for 2 weeks, with walking on the heel allowed from the outset for a period of 6 weeks. It is possible to move to appropriate shoes from 4 weeks. Swelling resolution and return to sporting activities can take 3 months.
These include less than 1% risk of wound-healing problems, infection and numbness in skin. Specifically for fusion, there is a 5% chance that the bones do not fuse and require revision. There is up to a 10% chance of a new pain in other joints of the foot.