Hallux Rigidus

1st MPJ (Metatarsal-Phalangeal Joint) Arthritis

Hallux Rigidus is a common cause for pain in the great toe joint, also known as the 1st MPJ. Hallux Rigidus is a form of degenerative joint disease (DJD), or "wear and tear" arhtritis, much like is common in the knee and hip. There is still much debate over the exact cause of Hallux Rigidus, but most physicians can agree that the most common causes are either related to faulty foot structure or a history of injury to the joint. Common symptoms include pain, especially with bending of the 1st MPJ, and intermittent swelling.

Stages of Hallux Rigidus:

  1. Inflammtion and Functional Limitation
  2. Joint Limitation with Mild Bone Spur Formation (Mild Cartilage Destruction)
  3. Severe Joint Limitation and Increased Bone Spur Formation (Moderate - Severe Cartilage Destruction)
  4. End-Stage Arthritis (Complete Cartilage Destruction)

There can be two kinds of pain associated with Hallux Rigidus: "Bump Pain" and "Joint Pain."

  • Bump Pain is when the direct pressure over the bone spurs, generally from shoes, cause pain.
  • Joint Pain is when motion of the joint elicits discomfort.

People can have both Joint Pain and Bump Pain, and presence of both types of pain is generally associated with more severe disease.

Evaluation

History and Physical examination are important to accurately diagnose what stage of disease you have, and to establish your activity limitations and goals of treatment. Pure "Bump Pain" can often be resolved much easier than advanced stages of the disease, but accurate diagnosis is critical to formulating a treatment plan. Foot x-rays are standard, and MRI or CT scan are rarely necessary.

Treatments

Non-Surgical treatments are consistent with treatments used for most other forms of arthritis. 

Surgical treatment options come in various forms, and most often are determined by the severity of the disease. Patient goals and desired activity levels also play a significant role in procedure selection, as the demands of a high-level athlete are different than those of a retired individual who's goals are solely pain free daily activities. Anticipated recovery time varies with each procedure and should be discussed with your surgeon.

Non-Surgical Treatments Include:

  • Rest
  • Ice
  • Oral or topical anti-inflammatory medication
  • Steroid injections
  • Custom Orthotics
  • Physical therapy

 

Surgical options Include:

  • Mild Disease
    • Chilectomy (Bone Spur Removal)
    • Synovectomy (Remove Diseased Joint Lining)
  • Moderate Disease
    • Chilectomy
    • Metatarsal Osteotomy (Bone Cut) To Better Align the Joint
    • Cartilage Replacement
  • Severe Disease
    • Joint Fusion - Gold Standard. High Predictability. Long Term Durability and Success.
    • Joint Replacement - Eliminates Pain in Joint, While Allowing Some Degree of Motion. Lower Long Term Predictability due to Implant Lifespan.
    • Partial Joint Arthroplasty (Cartilage Removal)


A complete evaluation is the best way to determine what treatment options are best for you. Call us at 512-593-2949 or CLICK HERE to Schedule an Appointment.