If arthritis pain persists despite medical treatment and interferes with your ability to participate in everyday activities, surgeons at NYU Langone may recommend foot surgery to relieve pain and improve joint function for the long term.
Foot surgery can be performed on the joint of the big toe, the joints in the middle of the foot, called the midfoot, or the joints beneath the ankle, called the hindfoot. The type of surgery your doctor recommends may depend on the severity of joint damage.
Debridement
If you have mild to moderate arthritis in the big toe, your doctor may recommend a procedure called debridement, also known as cheilectomy, in which a surgeon “cleans out” any pieces of cartilage, ligament, or bone interfering with joint movement. These stray pieces of bone and tissue accumulate as a result of increased friction in the joint as cartilage erodes and bones rub directly against each other. Debridement reduces pain caused by bone spurs or other irritants and may also increase range of motion in the joint.
Debridement in the big toe joint is performed in the operating room using sedation and local anesthesia, and you can expect to go home on the same day and wear a supportive shoe for a few weeks. Your surgeon schedules a follow-up appointment 10 to 14 days after surgery to ensure that the foot is healing as it should.
Fusion
If damage to the joint is causing significant pain and immobility, your doctors may recommend a fusion of two or more bones in the toe or foot. In this procedure, surgeons bind together the bones of the arthritic joint using small metal screws and occasionally metal plates. These bones begin to grow together, resulting in one fused bone. Joint fusion has the advantage of completely eliminating painful movement between bones in the joint.
Fusion is performed using local anesthesia with sedation or general anesthesia. This decision is made in consultation with your doctor and usually depends on your preference. Most people can expect to go home on the same day.
After the surgery, you need crutches to help you walk without putting weight on the fused bones. In addition to crutches, you should wear a protective splint for 10 to 14 days. At that time, doctors examine your foot and, if you are healing normally, provide you with a removable supportive boot. Crutches are usually necessary for another four to ten weeks, depending on the extent of surgery, and the boot should be worn for three months or longer.
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