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    fusion on big toe the mtp joint
    Tammythecrazycrazymadcowperson posted:
    I'm tired of the arthritis in my right big toe, I have had it in my toe for almost two years now due to injury and a incompetent podiatrist. Six months ago, I saw a orthopedic surgeon for it, he did say their was arthritis due not being treated properly and not the right surgery. He said to come back siv months later after recup time for prior surgery. He told me at that time my options would be a fairly new procedure podiatrists do(within 10 yrs.),or a fusion. The first procedure what I have researched, does not remove any of the arthritis, and sets you up for a toe replacement down the road. I have opted to go for the fusion. I'm tired of living with the pain,swelling and notbeing to move it(it has gotten worse in that six mon.(not being able to bend it up or down) I want to get back to some semblance of a normal life and be able to try to work. Has anyone out there had a fusion on the right big toe at the mtp joint? Can you tell me about the surgery, what they do? recovery? What the sucess rate was for you or any experiences? This would be great for me, to make a informed decision. Thanks for the help!
    lushdoc responded:
    Dear Tammy: I have not had a fusion of the big toe joint but have had several fusions of the foot joints and most of the recovery times I think are the same. It's too bad that you went to a bad Podiatrist because we have a Podiatrist in a town next to us that has been doing a procedure that I will be doing when an appropriate amount of time has passed. That is a partial joint replacement. The procedure is just being done by OS within the past little while as a new procedure while this Podiatrist has been doing them for over 2 years with pretty good success. I don't think you would be a good candidate for this procedure if you've already had procedures done and had them fail and your doctor thinks you would be a better candidate for fusion. A fusion just takes the joint and fuses it together so it no longer moves. You no longer have any pain or swelling or any of that stuff. I assume they do the same thing for toes as they do for feet. But, if they don't at least you'll have my experience. They put a cast on for 6 weeks, non-weight bearing, 4 weeks partial weight bearing then take the cast off put on a boot for 4 weeks. Then you should be okay. It's a long procedure. The reason I know is because I had 4 of those on my right foot and one on my left hand. Two of the ones on my right foot failed and had to be redone. It was not fun. And then to have the surgeons not believe you even reading the CT Scans and having the CT Scans telling them the surgery failed, was not fun. So, between each surgery I spent a year living with the pain because my surgeon wanted to make sure. I was miserable. There is always a possibility of a fusion, failing. I don't know how much with a toe joint but I didn't have any problems with my thumb joint. That one turned out fine. So, you just have to go through it and let the chips fall where they may. They will probably do a knee block so you can't feel the surgery and then sedate you. But that is up to each anesthesiologist. They will discuss it with you before surgery. Personally, if I was in as much pain as you are, I would do it. That is what happened with my thumb. I had just had it with the pain and just told him to get it over with. The recovery will be a bit long but it should be worth it. Good luck and let us know how it turns out. Linda Kennedy
    Tammythecrazycrazymadcowperson responded:
    Thanks lushdoc, Thanks for the reply, the new procedure your talking about could it be called resurfacing? This is the other procedure the doctor was talking about. The problem with resurfacing, that I have researched is, they do nothing with the bone as far as scraping to remove the arthritis,they add a thumblike screw to the end of the bone, to give you mobility, but do nothing with the arthritis. From what i have read is it makes you a candidate down the line for a joint replacement. I'm the type that wants to just get it fixed, not do a procedure and continue on down the road with arthritis to have a joint replacement. All I know is I am always in pain, have tried arthritis meds.,steroids and still continue to be in pain. Have to ease up on long standing, cut in half my routine due to the arthritis. I know right now I can't work because of it. I want to get back to a normal as possible life(a job, and to be able to do some of the things I use to do). Thanks for the info., I am seriously looking at doing the fusion. Sounds like what I have read about the fusion as far as recovery and casting. I expected it to be a long recovery. If it get rid of the arthritis, pain, swelling, I think I will be able to handle the recovery! Considering the surgery the podiatrist did, didn't fix the problem and was a six month recovery, that did nothing!!! Thanks for the info. and advice, I will definitely let everybody know. I see the doctor on Mon. to let him know how it'"s going and what I have decided. Will let all know.

    scubagirl123 responded:
    Hi Tammy I was reading this old post and wondering if you had the big toe replacement. I have been in major pain for 2 yrs and was told I need it replaced. My dr. said it was like a piece of wood no mobility just red and swollen! I had both feet down because of hammer toes and tendons and have had knee surgery due to arthritis and cortisone shots in elbow. I also knee a knee replacement. Many success stories about the knee but I've never talked to anyone that had the big toe done.
    rockylover replied to scubagirl123's response:
    I had joint replacement surgery on both of my big toes six years ago...put titanium joints in. The reason I had to have surgery is because I had arthritis...the surgeon gave me two options: titanium joint replacement or fusion. I chose the titanium joints. I have had pain every since the surgery...never had to wear surgical shoes, no orthodics prescribed, but did have to go to therapy. The therapist ended dislocating my big toe on my right foot!! I've been walking on the outsides of my feet for six years because of the swelling in the bottom/top of my feet...felt like I had "marbles" in the balls of my feet. Either the surgeon put too large an implant in (said I was between sizes so she put in a larger one) which irritated my tissues or my body simply rejected the foreign objects. Since I reached a point where I could not go for walks because of the pain, I opted to have the titanium joints removed and am now going into my third week of post surgery on my right big toe (1/2/13). The surgeon said my bone had grown into every nook and crany of the implant! He did not replace the implant with my toe is attached with ligaments and tendon. I had to sit in a chair with my foot elevated for two weeks and just got the stitches removed after 2 1/2 wks.. I'm walking in "Crocks" (most comfortable) and trying to teach my toe how to bend. It is still swollen and I'm taking Ibu and am weaning off the pain meds. I really don't know what to expect? My toe is now 1/2" shorter from having two surgeries. I'm very active and ride horses. I may put off the second surgery on the left big toe until late Fall and see how this's very "pliable." I have a friend that had her toe joint removed and not replaced with anything, but it wasn't the big toe...she has been doing fine. Has anyone else had their implant removed on htheir big toes and had nothing put in place of it???
    PattyPianissimo replied to rockylover's response:
    I have partial joint implants in BOTH big toes (hemicaps). I had these implants due to severe pain in my big toes from arthritis. I have been in pain since....the implants failed. I just had the implant in my left big toe removed on March 20, 2013. When the implant was removed part of my joint was destroyed in my big toe. The "orthopedic foot" specialist took bone from my hip to replace the destroyed bone in my big toe. He also put a plate to secure the "new" bone in place and that will remain there to keep the "new" fused joint from breaking. I have to tell you.....after the surgery....compared to the pain I felt "new" fused big toe had NO PAIN. I am 3 weeks post weight can be on the surgery foot....kind of a tough deal. Where they harvested bone from my hip hurts like heck....but that will heal. I am VERY anxious to get the other foot fixed....I will keep you posted on what it's like to bear weight on the bit toe with the hip bone in it.
    lovegoldens replied to PattyPianissimo's response:
    I had a titanium big toe implant surgery April 2012 by a podiatrist. I have been in agony since. I have gone to 3 othopedics surgeons. They all came up with the same diagnosis. Remove the implant and fuse with bone from my hip. Has anyone had this done. Is the hip and foot painful? What is the recvovery? Will I really PAINFREE?
    Cher1belle33 responded:
    They messed up my foot on routine bunionectomy. 5 surgeries later, I have a fused big toe with giant screw thru it and four pins in 2&3 toes. My big toe never hits the ground when I walk. It throws off my whole left side of my body. Many injections, several bouts of physical therapy, and I was told there was nothing they could do. I live in extreme pain most of time. Not only in foot, but it radiates up my leg, into my hip and lower back because my whole gait is off. I'm 39 years old and struggling to keep a job and take care of myself and daughter. Maybe some people have better luck, but its not a necessarily a miracle cure. Do your research and think long and hard.
    connie810 responded:
    I had a joint replacement in my large toe in Feb 2012. Shortly after I started having problems and finally really awful pain.
    My doctor was aloof and said I needed orthotics, which made the pain worse. Finally decided that there was something wrong with this podiatrist and saw another podiatrist who took one x-ray and said the fusion was outside of the bone area.
    He did another joint replacement, but said he was not pleased with the quality of the bone in the area and used had supported this with a plate. I was in pain from the day of the surgery on. Then the incision would not heal properly and I had an infection and needed revision of the incision. My foot felt highly inflamed. I went to see an orthopedic surgeon who said I needed a fusion and advised me to wait for one year due to the inflammation of the foot. By this time my insurance had run out. I ended up having the joint replacement that was loose in my foot replaced by a fusion by an orthopedic surgeon in Zabok, Croatia at a private hospital called St Catherine. In Surope they are not doing toe joint replacments due to the failure rate. This was six weeks ago and I am no longer in horrific pain.
    connie810 replied to lovegoldens's response:
    If your fusion is done correctly you should be pain free. I feel for you because my original failed joint replacement surgery was done in February 2012, a revision joint replacement in September 2012, and finally a fusion done on October 1st, 2013. My insurance had run out, so I had my fusion done in Zabok, Croatia at a private orthopedic hospital called St Catherine. I was also have a back problem at L4-L5 because my gait was way off. I found this hospital through a US skier who did not like his HMO and had back surgery at St Catherine in 2012. Currently, I am out of pain and so thankful to the wonderful staff at this hospital. Many people speak English in Croatia, it is their second language. Cost me $2600.00 for the surgery. Flew British Airways from Chgo to London, and then London to Zagreb for $1500.00. I am in my sixth post op week and should be weight bearing anyday. Keep the faith--Connie
    keyscritter replied to connie810's response:
    Hi Connie810, I was reading your post. How did you know your fusion failed? Was it strickly the X-rays or did yo have symptoms? I had a fusion 10/31/2014 and I am still having pain in the toe area below my toe nail, and on the top of my foot, and the ball of my foot (sesamoid ) area. I am getting very nervous about this and I can not find any symptoms online. Thanks in advance..
    skisx8s replied to lovegoldens's response:
    Yes, I had my second joint replacement removed, replaced with a section from my hip and all covered over by a titanium plate. Recovery and PT not a picnic but end result is worth it. Dr Caycedo in Birmingham, AL, St. Vincent's Orthopedics Sports Clinic is the best! Honest, direct and technically astute in his practice. I recommend him to to all in need!
    October 23rd, 2014 was my surgery. I'm a contractor and I have some discomfort after using ladders throughout the day but normal things like walking 2-3 miles\day are no big deal.
    Get through it and thank God for modern technology. (~;

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