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Old 11-08-2008, 02:34 PM   #1
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Alternative to MTP fusion surgery

Hello health board members. I am new so please excuse me if I make some protocol mistakes in this first post.

I had a cheilectomy on my right great toe joint 6 years ago. Last week my podiatrist looked at new x-rays of it because I am starting to have pain again. He said I have moderate to severe arthritic changes in the joint and would need either another cheilectomy type opeation or MTP fusion. I then started doing internet research and found reference to a procedure called Capsular interposition arthroplasty in an article dated 2006. You can google this article with this title: Capsular interposition arthroplasty offers an option over fusion for hallux rigidus.

Has anyone had any experience with this procedure? It sounds like they don't replace your joint with a mechanical one but use your own tissue instead. Are there any other options that anyone has heard of? I know I will have to resign myself to a pretty long recovery which ever way I go but I would like to go with the procedure that offers the best chance for me to walk normally after it is all done.

If you have been fighting a bad big toe joint I know what you have been going through. Any help would really be much appreciated.

 
Old 11-08-2008, 03:32 PM   #2
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Re: Alternative to MTP fusion surgery

Replacement of that joint does work sometimes, but the replacement often doesn't last long. Fusion is permanent, and most people who've had MTP fusion can walk normally afterward.

Anyone have personal experience to offer?

Last edited by janewhite1; 11-08-2008 at 03:32 PM.

 
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Old 11-09-2008, 07:41 AM   #3
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Re: Alternative to MTP fusion surgery

i had big toe fusion. i first had an implant, but it didnt work. its been 2 years and i am fine without any pain. i am not familiar with the procedure you are talking about. ask your dr what he thinks and let us know.

 
Old 11-10-2008, 08:24 AM   #4
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Re: Alternative to MTP fusion surgery

Quote:
Originally Posted by debbie g View Post
i had big toe fusion. i first had an implant, but it didnt work. its been 2 years and i am fine without any pain. i am not familiar with the procedure you are talking about. ask your dr what he thinks and let us know.
Thank you for your reply, Debbie. I will research the procedure I mentioned but it seems like the fusion surgery is the most widely recommended of all the alternatives. I have a feeling that I may have to go for the fusion and that isn't so bad I suppose. Would you mind telling me how long your recovery time was after the toe fusion? I am still working and I'd like to plan the length of my time off. My job is a mildly physical one so I will need to be able to walk pretty well before I can return to work. How long were you on pain meds after the fusion surgery?

 
Old 11-10-2008, 01:23 PM   #5
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Re: Alternative to MTP fusion surgery

from reading these boards, every fusion seems to be different. i had a cast for 9 weeks and then a walking boot for 4 weeks. the swelling takes a very long time. i know it takes about 1 year, but believe it or not more swelling went down now and its been 2 years. the pain meds maybe lasted about 3 days.

 
Old 11-11-2008, 07:35 AM   #6
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Re: Alternative to MTP fusion surgery

I have never done the interpositional arthroplasty procedure but did hear of it at a few conferences. Have not heard anything more about it since but can't imagine from the description of the procedure that it would be highly successful as I would think that this interpositional tissue will break down over time and you will be right back where you started with bone on bone. The idea of your great toe being fused is the only bad thing about the procedure other than the healing time involved. Once it is done unless you are a runner people get along great.

 
Old 11-12-2008, 08:44 AM   #7
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Re: Alternative to MTP fusion surgery

Thanks for your reply, JCPelly. As Debbie g said earlier every case is probably different but could you answer a couple of general questions, please? In your experience, how long does it normally take for the joint to become solid enough to walk normally? After full healing is the joint as strong as any other bone in the foot?

 
Old 11-12-2008, 02:31 PM   #8
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Re: Alternative to MTP fusion surgery

i think the joint is as strong as any other. walking is dependent on the type of surger you had.

 
Old 11-13-2008, 10:47 AM   #9
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Re: Alternative to MTP fusion surgery

yes once it is fused it is one solid bone. Takes almost a full year for the bone to fully heal but I use a plate and screws and recommend using crutches and just a little wt on the heel for 4 weeks then get rid of the crutches and use the heel only still in a camwalker for another 4 weeks then if x-rays look good let them in a good supportive shoe still walking flat footed until it feels good. If you don't have the plate and only have crossed screws then would not allow much wt at all for 8 weeks with crutches.

 
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