The most common site of arthritis in the foot is at the base of the big toe. This joint is called the metatarsophalangeal, or MTP joint. It’s important because it has to bend every time you take a step. If the joint starts to stiffen, walking can become painful and difficult.
In the MTP joint, as in any joint, the ends of the bones are covered by a smooth articular cartilage. If wear-and-tear or injury damage the articular cartilage, the raw bone ends can rub together. A bone spur, or overgrowth, may develop on the top of the bone. This overgrowth can prevent the toe from bending as much as it needs to when you walk. The result is a stiff big toe, or hallux rigidus.
Hallux rigidus usually develops in adults between the ages of 30 and 60 years. No one knows why it appears in some people and not others. It may result from an injury to the toe that damages the articular cartilage or from differences in foot anatomy that increase stress on the joint.
- Pain in the joint when you are active, especially as you push-off on the toes when you walk
- Swelling around the joint
- A bump, like a bunion or callus, that develops on the top of the foot
- Stiffness in the great toe and an inability to bend it up or down
If the nonsurgical treatments for hallux rigidus are not working, then surgery can be considered. When the arthritis is in the early phase and is located at the top of the joint as a bone spur, then this spur can be removed.
When the arthritis is more severe and the joint cartilage is completely worn away, the joint needs to be fused or locked in place to prevent painful motion.
A cheilectomy is a surgical procedure performed to remove bone spurs from the base of the big toe in the foot. Patients with a condition called hallux rigidis, or arthritis of the big toe, have pain and stiffness in the big toe.
The word cheilectomy comes from the Greek word Cheilos, meaning “lip.” A cheilectomy removes the bone spurs, or lip of bone, that forms as a result of arthritis of the joint. By removing the bone spurs, patients have less stiffness of the big toe.