I feel I need to say this to everyone considering joint implant / fusion.
Because......doctors can be lousy at telling patients all the facts.
Unless you poke & prod - you will be left uninformed.

When you get an implant - the bone marrow is reamed out to make room for the
new hardware so to speak. This is true with any implant.

In the event your implant fails initially... or.... over time, reaming out the marrow isn't really an option next time..... because much or most of it is gone

Since the marrow is needed in the healing process, if you get another implant, your big to say might be 1/2 to 3/4 inches long.. and healing will be difficult.
We can call you stubby !!!!!!

This is why many doctors still believe fusion to be a viable alternative.

Remember folks - ask all the questions. Get the facts.
What can happen short term & long term.

Talk to several patients who have had both surgeries recently and long ago.
Then do it. Don't base your descision on what 1 person says that "hey I just had an implant 2 weeks ago and feel great !! - implants are the way to go !!!!)

do your homework....

Hi,
I am lucky that my Dr. did tell me all of that, and since I am very active, and play tennis and run daily, I had the fusion on my big toe last Feb. Recovery was a bit long, with a cast and non-weight bearing for many weeks, but I can now run (better than before)..and wear nice dress shoes..finally!
I agree with Fuchsia_Lay, do your homework and do what is best for you. I am very glad that I opted for the fusion. No pain at all any more! And no future problems to worry about.
Best, Sue

Fantastic news !!!!!!!!!!!!

I'm having the implant done on Dec 22. I'm curious Fuchsia, how many years ago was your implant done? Technology does change, improvements are made.

Recently I spoke to our physical therapist at work, who comes in once a month to help our employees with their work related injuries. I asked her about her experience with people who had the implant. She indicated that she's only worked with one person who had the implant, about a year ago, and that the patient was doing wonderfully. She did indicate to me that she has also worked with several people who had the fusion, and some of the people had less than wonderful results. Not all fusions allow one back on the tennis courts.

I will be seeing my surgeon again next week. I did print out your prior post and will address the matter with him. However I do trust the judgement of my Dr. one hundred per cent. He has an excellent reputation in our area.

My implant was done 10 years ago.

The implant is perfectly intact looking @ x-rays.

Think about the motion of walking and what could possibly happen in time.
Again you can't measure success in a few weeks, months, maybe a few years.

My only contention is that if your implant needs redone or fails-
to cut back more bone to allow a new implant could be a disaster.

Yes - do your homework and do what you feel is best.

As for me 1 fusion - total 100% success 11 years later
Implant 1996 a disaster (sorry if I mentioned 10 years ago---mistake)
1996 is correct.
Implant didn't begin to have problems until 2 years ago. Again it isn't coming apart - it's what has happened inside and how the motion of walking has altered the function of the toe.

Again the test of time can be the only real measure... and yes please please
ask your doctor if your implant had to be redone or failed----what would be the consequences.

Good luck

This is a good time gang - all positive , negative comments welcome

F-L

Hi Fuchsia_Lay,
I appreciate your description of what is done to make room for the implant. For me, that really puts things into perspective. If I was faced with the decision, I would choose fusion, especially after reading about what happened to you. I have had enough problems with my feet already - way too many problems! And I don't want to be the 1st kid on the block to try the new technology - not with this anyway.

Besides that, I had a joint in my hand fused 3 years ago. That joint is painfree and my hand is much more functional now than before surgery. I did have a great hand surgeon (too bad he doesn't do feet!). I asked him about a joint implant at the time and he said he and the others in his practice quit doing the implants for the finger joints because of too many complications. I even read about a doctor elsewhere who had developed a new implant for that particular joint but it wasn't being done where I live. Even though it sounded good, I wouldn't have tried it. Too new for me to take the risk. Fusion has been around for a long time and has withstood the test of time. Sure, there are some failures but that is with any surgery. Since I had such good results with the hand joint fusion, I would do the same with my foot if need be.

I would rather have a longer recovery period with one type of surgery than to ultimately end up with a failure even though I had a short recovery time with something else. Well, that's my 2 cents worth and those are my thoughts. Thanks for starting this thread!

HI to all that posted here

Well I have read these post and actually I agree, the test of time is the key here but I feel great so far, and that is the issue here, Its been two weeks and too soon to tell how all things will come about when all is said and done, and I was one of those people here who had the fusion less than two years ago on both of my feet and I did not have success with the fusion and here I am again so I went for the implant, The first time I went through what all of you have gone through and everyone is different, but on that note I will say that I feel pretty good now after the implant and will continue to say its the way to go or at least it was for me because the fusion did not hold up and I had it done on both of my feet due to degeneative artharitis of the bone joints in both of my feet, infact the pins they put in were sticking up and hitting the bones, this time the surgery of the implant was done by a different Dr and I am so far impressed with the recovery and how things are going, Yes do your homework,an implant I do not understand why its so scarey for some, I agree though with a post here saying you need that marrow and the worse case senario that could happen is they would have to go in take out the implant and then take it out of your hip which with any surgery there are risk weather it be fusion verses implant, so Yes I agree the test of time will tell if all is successful and research is the best for anybody before surgery of any kind and do your homework, but after I talke with one of the best foot Drs in the country personally on the phone and did alot of research that I opted for the implant.
Its all a matter of choice and whats best for you, for me I said lets go for it.
I agree with Jeff here a friend of mine on this list and whom I have been e-mailing back and fourth, He is getting ready to go in a have this surgery, and I am sticking with him on this matter of that its up to you and to trust your Dr thats what we pay them for and that what they went to years of school to help us to understand whats best for you and give you those options on what to do.
I can not tell you what to do, only you can decide, Also I agree with him in the fact that some of you that have had implants in the past may have had them years ago, and say you are not doing well, Was it titanium,etc, and its like times have changed and things are much more advanced now than they were 10 years ago etc, its like anything in our world, things have changed and technology is so much more advanced now. I mean look at the heart patients, the diabetics, I have a step daughter who is now on an insulin pump she is type on diabetic and her blood sugars are awesome now and way better than they used to be because of the advanced technology we have in medicine, this goes for titanium, joint replacements, or whatever, Its way further advanced than it used to be.
Some may agree with me, some not, I am not here to start an issue I am just stating that everyone is different, Our Medicine world is much different, and on that note so far after two weeks I am feeling pretty good and time yes will tell.
Blessings to all for a Wonderful Christmas Season.
Karrie from Washington

I have to say that I am disappointed with this entire thread. Essentially we've had two people comment on the implant vs fusions in a very unfair comparision.

Everything we've read has been about the worse case senerio for the implant compared to the best case senerio for the fusion.

Trust me, after a fusion most people won't be bouncing back onto the tennis courts. I'm happy for the lady who has been able to do that, but she's the exception, not the rule.

I've never heard either of those two posters mention the potential bad effects of the fusion. They do exist. People who undergo a fusion can end up with a minor limp, or a change in their stride. If the fusion wasn't done at the exact proper angle, special shoes, with a large "toe box" or orthotics may be necessary. There is no promise that a fusion is a miracle cure. Some fusions simply don't work.

I was going to post, after my surgery, to keep people informed as to my progress. I thought this may help provide information to fellow foot sufferers. However, I really don't want to subject myself to the " well, it's only been two weeks" comments as Karrie was subjected to. Actually I found those comments to be rather cruel.So I won't be posting concerning this subject again.

To Jeff:
--------------------------------------------------------------------
Trust me, after a fusion most people won't be bouncing back onto the tennis courts. I'm happy for the lady who has been able to do that, but she's the exception, not the rule.
----------------------------------------------------------------------
Jeff - Please point us to the studies you read that detail this .
Because-- I too have had 0 problems with fusion.
Point us to the fact based studies.

Compare LONG TERM studies on fusion vs implants people.

I will RESTATE things since people DO NOT seem to be hearing what I am saying. My implant DID NOT fail - 100% intact as we speak.
The walking motion over the years (and think about the stress on that joint as you walk)- has caused things to function in a different way I guess we say.
Yes ask your doctors about this. More than just the implant needing replaced or failing--ask what else could happen with an implant over time - how the toe might function differently..
Not trying to be the bearer of bad news--ask for the long term studies on
implants and how walking will impact the way your tootsie functions over time. Chances are doctors will not know this. A doctor will say--hey "an implant will replace the deteriorated cartilage--and all will be fine.." end of story...

We are all finito believe me & everyone is now well informed on joints.
We have beaten this until it cannot be beaten anymore.

Don't be disappointed by any thread people.
Consider yourself with raised awareness.

OK we are all done

I have to say I have found this thread to be very informative. I am dealing with a dislocated great toe and looking at the options. JeffH I hope that you will reconsider and post your progression after surgery.

I have heard and read both good and bad about both, implant and fusion and am trying to determine what is in my best interest. I have been pushing my doctors for answers and have another list of questions for them. I plan on making my decision with as much information as possible, everyones situation is different as well as their access to talented doctors.

I wish all of you the best!

-eko

Eko, thank you for the kind, positive comments. I may in fact change my mind and post about the progress of my surgery. I'd really like too.

I'm still upset about Fuchsia's comments to Karrie. It's one thing to talk about different types of surgeries, recovery times, and success and failure rates as matter of general discussion. However when a post-operative board member posts to the group with news of her progress in the weeks since her surgery, it is simply cold hearted and mean spirited to say to that person.."well it's only been two week. You can't tell if it will be successful until several years down the road." I ask you, would you say that to a friend who just had cancer surgery? Of course not. It shouldn't have been said to Karrie. She deserves an apology. When someone has surgery they should then be supported by the group, period.

If I do post I will stop the first time anyone says ...it's only been two week...much to soon to tell if it worked."

Let's talk about doctors. The author of this thread seems to hold them in low regard based on the title of this tread. Let me tell you about my Doctor. Last week I went in for my pre surgery lab work. The lady doing the paperwork scanned mine and stated "Oh you have Dr. P. You're very lucky." She went on to describe her experiance with him during and after her bunion surgery about a year ago. She was glowing with praise. I wasn't surprised. About two years ago I called his office with a ingrown toe nail, with a minor infection starting. I mentioned to the receptionist that being that I was mildly diabetic that I should probably have it looked at. We set up an appointment for early the following week, which was fine with me. About a half an hour later, I got a call from the Drs. office. It wasn't the receptionist, it was the doctor. He told me to come in the next morning and that he would fix my toe nail.How many Doctors take the time to personally call their patients back? Not many. My Doctor is a prince. He can't promise me that the implant will be a total success, but I can promise you that he would not do the operation if he didn't think the success rate was very favorable.

Part two in a minute

I'm back.

I'm the first to say that an implant isn't for everyone. Neither is a fusion. It depends on each persons individual circumstances. I do believe that this is the best medical alternative for me. Other than that, there are several other reasons why an implant is best for me at this time. I'll share a few of them with you.

My job is an issue. I simply can't afford the six to eight weeks away from the job that would result from a fusion. It's not about the money. I would get paid for every day that I would miss. As a matter of fact, a few years ago I was off for 2.5 months on an unrelated matter and was paid for the entire time. For one, I don't want to put my company through this again. I'm not a high level executive, I'm just a "cubicle worker." However over the course of the last twenty years at this firm, I've aquired a rather large degree of responsibility and authority. A lot. The company would be "in a bind without me." To make it worse, my former boss left us a few months ago. My new boss has less than a month on the job. It will take him several months to learn his job. I certainly can't saddle him with my duties at this time. Heck, he barely knows what my duties are at the present. In fact that's why I scheduled my surgery for Dec 22. Our company will only operate three days that week and three days the following week. I felt by scheduling the surgery then, I could miss fewer work days, as due to the holidays there would simply be fewer work days!!! Call me loyal, call me stupid. However I did attempt to schedule this at a time that would "hurt" the company the least.

I've also got carpal tunnel syndrome. It's minor to moderate. However I can only imagine what six weeks on crutches would do to my wrists. It certainly wouldn't help them and could most likely accelerate the carpal tunnel.

My work area is located on the second floor. There is no elevator. The stair climbing restriction as comes with the fusion, would be a major hassle

So for various reasons, the implant is best for me. If I were of a different age, on a different job and without wrist pain, I may have made another choice. I may not have. Who knows? All I know is that at the present time, I've made the best decision available to me.

JeffH

sorry there will be no aplogies to the care's statement
i've just had an implant 2 weeks ago--- it's the way to go !!

you can't measure success after a few weeks.
sorry - this isn't cruel - but you cannot tell people it's the way to go after
such a short period of time. common sense ....

yes the fusion takes longer to heal.
Implant may be shorter

what happens down the road ????? time will surely tell

finito

wait lets touch on that comment from JeffH that the author of this thread hold doctors in low regard.
I said what doctors don't tell you...
JeffH did your doctor tell you he will be reaming out your bone marrow to
do the implant ? if it fails or has to be redone etc. bone may have to be cut back to do another implant. Were you told this? Were you told over time things may change inside your foot with an implant ? The implant may stay intact but things may change. It's all I was trying to point out starting this thread hold doctors in low regard ??
You need to read things closer

JeffH, I can appreciate your situation and respect your decision to have he implant. I also can fully relate to your situation at work. I was off six weeks this fall for a Brostrom Repair and Bunionectomy. I was fortunate that I was able to do some work from home.

Despite the comments from F-L, I do hope you and Karrie will continue to post your progress. Personally I am leaning towards a fusion, but have not made a final decision. As far as what the future holds for any procedure, time will tell. There is risk with fusion as there is with an implant. Maybe you or Karrie should start a new thread just to tell your progress. Dodgy Toe just had a fusion done this week and I have asked him to post his progress as well. The purpose of the board is to allow people to share their common experiences to others can learn.

Again, I wish you all the best. -eko

Eko- Thanks once again for your comments. As I stated I would never try and talk anyone out of a fusion or to convice them to have an implant. As I explained above, it's a decision best arrrived at, at least for me, after reviewing many different pieces of the puzzle.

Good luck and if you don't hear from me have a happy holiday season!!!

My implant was done 10 years ago.

The implant is perfectly intact looking @ x-rays.

Think about the motion of walking and what could possibly happen in time.
Again you can't measure success in a few weeks, months, maybe a few years.

My only contention is that if your implant needs redone or fails-
to cut back more bone to allow a new implant could be a disaster.

Yes - do your homework and do what you feel is best.

As for me 1 fusion - total 100% success 11 years later
Implant 1996 a disaster (sorry if I mentioned 10 years ago---mistake)
1996 is correct.
Implant didn't begin to have problems until 2 years ago. Again it isn't coming apart - it's what has happened inside and how the motion of walking has altered the function of the toe.

Again the test of time can be the only real measure... and yes please please
ask your doctor if your implant had to be redone or failed----what would be the consequences.

Good luck

This is a good time gang - all positive , negative comments welcome

F-L


Fuchsia and Others,

I have really been thinking about this post, and honestly, Here I am in the my third week,and I am walking and bending my toe, I agree with the test of time of course, but on the other hand people have hip joint replacements all the time and so why is it that when you mention a total joint replacement on your foot they tend to cringe at the thought, Just an opinion, Yes I agree to do your homework and do what you think is best for you, but so far I am impressed, and honestly they did not even make the new titanium that many years back and the new modern technology is so different now.
Yes we all have issues it seems with this implant thing, but think of it this way the worst that can happen down the road for me is they would have to take it out and take a piece out of my hip, but you know what anything can happen no matter what kind of surgery you have so on that note, I will leave saying its all a matter of choice, and I am glad so many have had success with what I had don, obviously not on this post but Its worth putting my two cents in, and I do appreciate other comments, I can also understand how so many can be sceptical, I survived and I will survive it and proove that it is going to be and continue to be successful, I am ready to do it again, the recovery is amazing and less than a fusing, and even though a Dr may tell you fusing is better, you have more mobility with a titanium and I am going to say it again TITANIUM implant, If you need more info talk with the Foot and Surgeon specialist in Philadelphia Medical he is one of the top Drs in the country and has wrote many articles on the subject.
I know Fuchsia and others, that yours may have had issues, but I have asked you this before I do not think it was titanium they did not even have titanium over seven years ago, so that could of been a problem right there.
Also I am not saying here that I can really tell you how I am doing because there has not been enough time to tell, I was just stating that for now its incredible how I feel, I am now walking, still not in normal shoe yet, but last time I had the fusion done a few years back I still suffered alot of pain and thats why for me going with the implant was the only option. You either pick one of the two, and honestly would you rather have more mobility or none at all its your choice.
I did my homework, I know what could or could not happen and I am impressed so far.
Blessings to you all
Karrie

I am looking forward to talking with My friend on here, and how he will do, and then we will have both of us telling you all was a success it was thus far.
He will be going in soon, and I pray he also has the same progress and success I will be having.
All of us are different, and all of us make choices on what or what not to do.
If implant is good for you go for it, If Fusion is your choice go for it, but whatever you do, Please do not judge the one time failer to others, My fusion failed on both of the joints, so on that note, what option did I have you tell me?

JeffH


wait lets touch on that comment from JeffH that the author of this thread hold doctors in low regard.
I said what doctors don't tell you...
JeffH did your doctor tell you he will be reaming out your bone marrow to
do the implant ? if it fails or has to be redone etc. bone may have to be cut back to do another implant. Were you told this? Were you told over time things may change inside your foot with an implant ? The implant may stay intact but things may change. It's all I was trying to point out starting this thread hold doctors in low regard ??
You need to read things closer

Yesterday I showed your comments to my Dr. He explained that there would be very little bone marrow loss with this implant. He indicated that even with a worse case senerio, if the implant had to be removed, the toe length would not be shorter,and a fusion could be easily done. He also offered up a list of many people who have successfully undergone this surgery. I felt no need to actually get the list from him. His credentials are impeccable. He doesn't lie.

So....question "asked and answered."

............time to undergo the knife then .............

if the implant had to be removed... the toe wouldn't be shorter if fusion was done ? how can that be possible ? if your cartilage is removed (your nice cushy spacing) and the bones are fused how can things not get tighter ?

doctors know best

let us know your short term and log term outcome

............time to undergo the knife then .............

if the implant had to be removed... the toe wouldn't be shorter if fusion was done ? how can that be possible ? if your cartilage is removed (your nice cushy spacing) and the bones are fused how can things not get tighter ?

doctors know best

let us know your short term and log term outcome

Well, I went to two doctors on opposite ends of the spectrum. I did my homework.

The orthopedic surgeon wouldn't do the implant. However he did tell me he would not discourage me from having the implant. He also indicated that if the worse case senerio happened and the implant failed, it could be removed and a fusion could be done. He did indicate that it could be a bit more difficult, but again he stressed that it could be readily done.

My podiatrist of course endorses the implant. He too has indicated that if the worse case senerio would happen, the implant could be removed and a fusion performed with minimual problems.

That's two different doctors. Who should I believe? You Fuchsia or the TWO different doctors? I think I'll go with the doctors.

At this point I'm convinced that there is nothing I could tell you about an implant that would result in a single positive comment from you.

Are this narrow minded with everything in your life, or just this one issue?

I will NOT be posting my short or long term progess to this board. I don't need to hear from you that " it may be fine after two weeks, but tell us how it's holding up in 37 years."

I'm not even coming back to check to see if you responded to this post.

JeffH, I just want to wish you the best with your surgery. Take care!

That's two different doctors. Who should I believe? You Fuchsia or the TWO different doctors? I think I'll go with the doctors

nothing different than what i've said.
fusion not as easy if you have an implant first.

2 weeks or 37 years - good one.

you will come back - cause this place is addictiveeeeeeeeeeeeeeeeeee

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------OK - lets hear from all you toe joint implant people.
Lets hear the success stories--short term (2 weeks) & long term (37 years)