Patient Education: Debridement of the First MTP Joint

THE PROBLEM

The first metatarsophalangeal joint (MTP) is the joint where the big toe meets the foot. It is one of the most common joints in the body to get arthritis. In most cases, we cannot find a specific cause.

Usually, a large ridge of bone forms on top of the joint (some doctors call this a "bone spur" or "exostosis.") This keeps you from pulling your big toe up and causes pain when you try. It also keeps the toe from gliding normally and this can make the arthritis worse in the rest of the joint.

We call this problem "first MTP arthritis." Other doctors may call it "hallux rigidus" or "hallux limitus." They all mean the same thing.

Most patients who have this problem can be helped by removing the bone spur on top of the joint. We call this a "debridement" or a "cheilectomy." This lets your big toe pull up more normally as you walk. Although the amount of pain relief you may have depends upon how bad the arthritis in the joint is to begin with, the vast majority of patients we recommend the surgery to get at least partial relief.

Although the bone spur does not usually grow back, the arthritis in the rest of joint can sometimes continue to get worse over a number of years. If this happens other surgeries such as fusing (stiffening) the joint may be necessary in the future.

AFTER THE SURGERY

The surgery is done as an outpatient (you do not need to be admitted to a hospital).

DAY OF THE SURGERY: You will have a tight ACE wrap on after the surgery to control bleeding. YOU SHOULD TAKE THIS OFF 6 HOURS AFTER THE SURGERY. LEAVE THE BANDAGE UNDERNEATH IN PLACE.

1 MONTH: We will see how well your toe is moving. More visits are sometimes needed.