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Valerie1404 05-19-2008 01:53 PM

1st MTP Fusion vs. Hemi-arthroplasty
 
Hi,
I would like to hear peoples' experiences with getting their MTP toe joint fused and/or hemi-arthroplasty.

My surgeon has put me in a clinical trial where I will be randomly assigned to either get the fusion or the half-joint replacement for my arthritic MTP toe joint. I won't know which group I'm in until I'm on my way into surgery. I live in Canada where the half joint replacements are considered experimental and not funded, so this random trial is the only way I can get access to this procedure.

I am EXTREMELY UNEASY and considering bailing out and just getting a cheilectomy, a temporary fix at best. I am very uneasy with the prospect of having my joint permanently fused. If I could be assured of getting the joint replacement, I'd be more confident, but my odds are only 50%.

On the other hand, I have waited four years for this surgery (public healthcare, equal lack-of-access for all!) and don't want to miss this opportunity.

For those of you who have had a MTP fusion, are you glad you did it? Can you still run and walk up hill? What about the half joint replacement? Anyone with good results with these? I've read of many failures on this message board.

My status right now: the toe is extremely sore, but I can walk reasonable distances. I can flex the toe a little, and wear 2" heels as long as I don't walk far in the them. In the last two-three months it has started hurting a lot more (night, when I'm not walking) although not enough to take painkillers. I am a very active person, age 48.

Thanks,
Val, Toronto

Titchou 05-19-2008 04:16 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
I don't understand why you are skipping the cheilectomy. If you aren't having to take any pain meds yet, this should be a sign you're a great candidate for one. I couldn't walk without my Vioxx before mine! Now I dance, jog, wear heels (2") without pain. I had mine about 5 years ago and was told it should be good for 10-20 years or more. Shaquille O'Neal had one in 2002 and is still playing ball. If you have it, perhaps by the time you need the transplant it won;t be experimental any more.

debbie g 05-19-2008 06:25 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
i would not have toe fusion yet. that should be the last resort. please read all the prior posts on toe fusion.

oscodagp63 05-19-2008 06:25 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
Here are my 2 C worth. 11years ago I had my right great toe fused by an OS. The surgery was to have been to simply trim and make usable my rt great toe. When I came too I was in a cast and the DR. said he had fused the joint as it was beyond repair. I was mortified! At any rate, within a month or so I became much more comfortable with the 2 screws no plate surgery. Fact is, on my 2nd visit post op I made a point of telling the Dr. that I did not believe humanoids need that joint at all and am still of that opinion. That was the 1st great toe fusion, I am now sitting hear with a gauze wrapped blood seeping left great toe fusion witch was done by the same OS only in this procedure he used a pre formed plate. That was 7 months ago and the toe has been a problem right along. The procedure today was to have that $#@@ plate removed. So I am able to talk with fair knowledge of the fusion part. I have a friend that had the implant and found that to have been the wrong decision and then did a cartilage fusion. He is now pain free. Since today's surgery to remove the plate, I already feel my foot will be more comfortable. there is little pain and other than waiting for the incision to heal I will be better off. This Dr is one of the best around hear and I should have insisted he do the 2 pin fusion, but time is $

Valerie1404 05-19-2008 08:36 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
The problem is that the surgeon is so busy... and so in demand... that one only gets a few minutes to make a very difficult decision. His statement, "I can just cut the bone away, but it will eventually come back. Or you could get the fusion and that would take care of the problem permanently. Your choice."

At that point I pushed him on the joint replacement idea and he offered the clinical trial.

I'm still on the fence. I'm going to consult with a friend of my husband's, a very experienced podiatrist, to see what he thinks. He can analyze my gate, measure my flexion etc... and give me an experienced view of just how much time the cheilectomy might buy me...

Regardless, I'm going to go through foot surgery next month anyway because I also have four hammertoes that need to be fixed (I had that surgery done last year on the other foot - by the same surgeon- and it was 100% success!).

memar08 05-20-2008 10:08 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
I am now 2 1/2 weeks post op mtp fusion I had a failed cheilectomy almost 2 years ago problem was grade 3 arthritis I tried to live with the pain used orthotics wore only dansko shoes (stiff sole) and finally went to another orthopedic who felt only option at this time was fusion he does feel hemiarthroplasty works well in active people and the success rate is only 50% so here I am s/p fusion and can't wait to get up and wallk painfree being nwb and on crutches for 6 weeks will hopefully be worth the wait only time will tell

oscodagp63 05-22-2008 04:26 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
[QUOTE=Valerie1404;3575626]The problem is that the surgeon is so busy... and so in demand... that one only gets a few minutes to make a very difficult decision. His statement, "I can just cut the bone away, but it will eventually come back. Or you could get the fusion and that would take care of the problem permanently. Your choice."

At that point I pushed him on the joint replacement idea and he offered the clinical trial.

I'm still on the fence. I'm going to consult with a friend of my husband's, a very experienced podiatrist, to see what he thinks. He can analyze my gate, measure my flexion etc... and give me an experienced view of just how much time the cheilectomy might buy me...

Regardless, I'm going to go through foot surgery next month anyway because I also have four hammertoes that need to be fixed (I had that surgery done last year on the other foot - by the same surgeon- and it was 100% success!).[/QUOTE]

Im not much on Podirtrists. OS are the best bet when it come to bone work. Ive known to many people with bad podirtrists proceedures. skip the fake joint and go for the fusion, I know mine are both much better now.

JudyBear 06-02-2008 01:42 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
[QUOTE=Valerie1404;3575142]Hi,
I would like to hear peoples' experiences with getting their MTP toe joint fused and/or hemi-arthroplasty.

My surgeon has put me in a clinical trial where I will be randomly assigned to either get the fusion or the half-joint replacement for my arthritic MTP toe joint. I won't know which group I'm in until I'm on my way into surgery. I live in Canada where the half joint replacements are considered experimental and not funded, so this random trial is the only way I can get access to this procedure.

I am EXTREMELY UNEASY and considering bailing out and just getting a cheilectomy, a temporary fix at best. I am very uneasy with the prospect of having my joint permanently fused. If I could be assured of getting the joint replacement, I'd be more confident, but my odds are only 50%.

On the other hand, I have waited four years for this surgery (public healthcare, equal lack-of-access for all!) and don't want to miss this opportunity.

For those of you who have had a MTP fusion, are you glad you did it? Can you still run and walk up hill? What about the half joint replacement? Anyone with good results with these? I've read of many failures on this message board.

My status right now: the toe is extremely sore, but I can walk reasonable distances. I can flex the toe a little, and wear 2" heels as long as I don't walk far in the them. In the last two-three months it has started hurting a lot more (night, when I'm not walking) although not enough to take painkillers. I am a very active person, age 48.

Thanks,
Val, Toronto[/QUOTE]

JudyBear 06-05-2008 10:05 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
Hi,

As I was reading your messge Val, I realized we have a few similarities. I had surgery done 5 years ago which was a total reconstructive surgery and in the end my big toe which the 1st and 3rd joints were fused, was suppose to bend. The second joint was left alone but from day one it never moved and was very painful. The cartalidge has worn away and the joint has become arthiritic. I used to be a very active 48 year old and my life has totally changed. I don't work, don't get out much, can't do many activities and I use a cane or wear a cast boot to get around. Grocery shopping is now a challenge for me. I did alot of research on the internet 3 years ago and found a doctor in the states who said he would do toe joint replacement for me but it is very very expensive and he is hours away so to go back and forth would be hard. He suggested a doctor in Canada, who it usually takes 2 years to get into and 2 years for surgery. They did get me in within 9 months but I have been waiting for the surgery for 1 1/2 years and I haven't heard a thing. I have seen many many doctors since and most are against toe joint replacement, they suggest fusion which I don't want to have until I try the toe joint replacement as I know you are way more limited in your use of you foot. I love to cycle, work out and walking used to be my everyday activity. Not many doctors do the toe joint replacments in Canada, more in the States. I was wondering first of all how you got into this program and where it is. I would be worried also about which one I had but I think you are lucky to get into this. Do you have to pay for this proceedure? The thing I worry about is the fact that because I limp really bad my back and other areas are giving out. The longer I wait for surgery the worse I get. I also had all of my small toes fused but they are now curled under and get in the way when I try to put shoes on. I had never heard of cheilectomy, no one has ever suggested it to me, something to look into. Good luck if you decide to go for it, I would like to hear which one you had and the outcome.

Would like to hear from anyone who has had either a toe joint replacment or fusion and your results, it is a very confusing decision to make and I am still in limbo.

Thanks

debbie g 06-05-2008 07:00 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
is an implant the same as joint replacement? implants usually dont work which i have experienced. the toe fusion stopped the pain. you can still be active-its changeing shoes to accomodate the fusion.

memar08 06-14-2008 09:35 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
to all out there who are wondering about fusion versus replacement I had a fusion 6 weeks ago and am just beginning to weight bear in a surgical shoe with one crutch i can actually walk without any crutch but my gait is abnormal and am having some knee pain so now will be using crutch until stronger I had originally considered joint replacement but was told by 2 orthopedic surgeons that only 50% success rate I had cheillectomy 2 years and never really had any pain relief My orthopedist promises no more pain after recoverfy and just to be able to return to normal activities painfree is worth these 12 weeks of total boredom do lots of research talk to people who have been through both and ask lots of questions good luck!!!!!

corkeysue57 10-21-2008 08:39 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
[QUOTE=Valerie1404;3575142]Hi,
I would like to hear peoples' experiences with getting their MTP toe joint fused and/or hemi-arthroplasty.

My surgeon has put me in a clinical trial where I will be randomly assigned to either get the fusion or the half-joint replacement for my arthritic MTP toe joint. I won't know which group I'm in until I'm on my way into surgery. I live in Canada where the half joint replacements are considered experimental and not funded, so this random trial is the only way I can get access to this procedure.

I am EXTREMELY UNEASY and considering bailing out and just getting a cheilectomy, a temporary fix at best. I am very uneasy with the prospect of having my joint permanently fused. If I could be assured of getting the joint replacement, I'd be more confident, but my odds are only 50%.

On the other hand, I have waited four years for this surgery (public healthcare, equal lack-of-access for all!) and don't want to miss this opportunity.

For those of you who have had a MTP fusion, are you glad you did it? Can you still run and walk up hill? What about the half joint replacement? Anyone with good results with these? I've read of many failures on this message board.

My status right now: the toe is extremely sore, but I can walk reasonable distances. I can flex the toe a little, and wear 2" heels as long as I don't walk far in the them. In the last two-three months it has started hurting a lot more (night, when I'm not walking) although not enough to take painkillers. I am a very active person, age 48.

Thanks,
Val, Toronto[/QUOTE]

corkeysue57 10-21-2008 08:51 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 


I had hemi-arthroplasty joint replacement 14 monts ago. Although the operation was performend correctly and the transplant was aligned perfectly I am in the same pain and swelling as I was before the operation and would not recommend this to any one else if I were asked. I too, was in a blind case study and was not given any false expectations but I did expect it to be at least as good as a fusion. In my case,at least, I do not have any more motion than I did before(20%) and I would have to say the pain for the first 3 months following the operation was extreme and I had to go to work on it. I faithfully did post op exercises but they did not help. I am at the point now where fusion is recommended but knowing the pain involved I am gun shy. Has any one else had a fusion after a joint replacement? Difficult to get Post op advice on anything.

debbie g 10-21-2008 05:37 PM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
i had joint replacement and it didnt work. why do you need the fusion to begin with? i had it and i can do almost everything. singles in tennis would be the hardest for me because i am not used to all the running. i can wear 2 inch and more heels, but not pointy.

corkeysue57 10-22-2008 05:00 AM

Re: 1st MTP Fusion vs. Hemi-arthroplasty
 
I need fusion because the operation did not relieve any of the pain. Was recovery as painful after fusion as the joint replacement. Did you have to get a bone graft from hip? I am self employed and cannot take any time off.


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