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Old 10-23-2011, 07:16 AM   #1
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Chronic sesamoiditis - finally offered sesamoidectomy.

Hi all

I was googling sesamoidectomy to help me think of any questions I wanted to email through to my surgeon, and came across a number of threads about it here, after finding very little information about it.

I have now finally been offered a sesamoidectomy and have subsequently booked it for March next year (I could have had it done over the next month or so but as I am in Perth, AU and Summer is looming along with a favourite festival early March, I decided to wait it out at the surgeons suggestion!).

I am terrified that I will not get the relief I am after even from this surgery, but I can't live like this anymore. I am constantly teary over being unable to do anything and being in chronic pain, and after nearly 4 years (I have just turned 24) and every other treatment under the sun I have decided that sesamoidectomy is a risk I just have to take.

Please share your experiences, advice, recommendations, suggestions etc as you see fit. I would love to hear from anyone who has had this done, especially in Australia and particularly from anyone around my age who has been through this. What I really want to know is - is life better now, can you run and can you wear heels without limitation?

Thanks for reading!
Jas

Last edited by mod85; 10-23-2011 at 08:27 AM.

 
Old 10-23-2011, 08:39 AM   #2
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

What are y our symptoms and what all have you done so far? A little history would be beneficial.

 
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Old 10-23-2011, 11:08 PM   #3
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Hi Titchou

this is from about 12 months ago:

I am a 23 year old female with chronic sesamoiditis spanning the last 3 years, I have been unable to walk without chronic pain for the last 12 months. In the last 3-6 months I've become practically immobile with pain.

Over the last 12 months I have seen a GP, Podiatrist, Physiotherapist, Sports Doctor, and finally an Orthopaedic Surgeon. I had an X-Ray, Ultrasound and MRI which I was told all came back normal until the Surgeon looked at the MRI films and said that the medial sesamoid was not lit up on the MRI at all which was in fact abnormal. Up til this point no one has been able to give me a diagnosis on what was wrong.

The podiatrist gave me orthotics and told me never to walk barefoot or wear anything other than sneakers with the orthotics in them. I did this for 6 months along with Ultrasound therapy, icing, stretching, and a whole bunch of other completely useless things that the podiatrist and physiotherapist recommended. I then saw the sports doctor (Scott Isbel at Sportsmed Subiaco if anyone is in Perth) who wasn't happy with the orthotics and sent me back to the podiatrist to have them adjusted after 2 cortisone injections through the top of the big toe joint. The first injection gave me about 4 weeks of relief before it wore off very quickly. The second one did nothing. At the time the second injection was given I was placed in a rocker sole shoe for a couple of weeks to no avail.

He still wasn't happy with the old orthotics (only about 6 months old). These orthotics were fibreglass ones with a metatarsal dome in them. I then had another set made, they're made of some sort of foam stuff (I guess) with no dome which were made through Sportsmed. Still no relief, I was then placed in a Cam walker for 6 weeks between then and when I saw the Surgeon. This also made NO difference to the pain (which was still undiagnosed at this time).

After seeing the Surgeon he was quite sure that the problem was related to the sesamoids, briefly discussed surgical removal of the sesamoid but wanted me to have a bonescan to be sure of the problem. 2 days later I had the bonescan and another 2 days after that returned to the surgeon. The bonescan only showed "MILD" sesamoiditis and arthritis of the big toe joint. The Surgeon changed his tune completely, not wanting to do a sesamoidectomy due to the high risk of complications. He said from a legal standpoint if the surgery left me unable to walk and I sued him, he would be in strife for performing the operation on a "mild" problem. He ordered a 3rd cortisone injection (in as many months), this time under CT.

I had that done - 45 minutes and 6 needles as they couldn't get it right - and still no relief. I've been walking on the side of my foot quite consciously due to the pain and now have pain around the third metatarsal joint as well!

The Surgeon said if the injection didn't help to go back to him, which I am on the 14th of January, but I've decided I DON'T want the surgery as he has convinced me there is a high risk rate, the surgery has an unpredictive success rate and I will never run or do any high impact exercise again after it. I may not even get any relief from the pain. I've not found ANY cases where a sesamoidectomy provided the intended relief, infact everything I've read is the opposite.

PLEASE can anyone tell me what else I can try? I'm at my wits end. I'm a 23 year old female who is essentially immobile due to this pain. I can't walk let alone exercise on the foot. I've got very limited range of motion in the big toe joint and cannot even flex my toe upwards 50% of the way as my good foot. The pain is close to unbearable and I've hit a brick wall with every "specialist" I've seen about this. I have visible swelling along the bottom of the foot and it is very sensitive to touch, sometimes it is also very red. Not even icing and NSAIDS can control the swelling, let along the pain.

 
Old 10-24-2011, 05:06 PM   #4
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Of course, I don't know what all you've done nor all the details, but a few things stand out to me:

1)No one has addressed the turf toe(tennis toe, runner's toe, etc) you obviously have. You have minimal ROM by your account and didn't mention any doctor commenting on it. Has no on suggested removal of the chips and spurs that are impeding movement?

2) There are such things as lidocaine patches that can help at least take the edge off. It's a numbing med.

3) It's true that sesmoidectomies are not all that successful. But they should be able to offer some strategies for the pain. I'm not sure about how health care works there but are there sports med orthos who do only feet? If that's so, I'd find the best one around and see what he has to say. Is there a pro football/rugby team there that you could call to see who they use?

 
Old 12-02-2011, 09:11 PM   #5
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Congratulations on the scheduling of your sesamoidectomy.

I would say it is definitely a step in the correct direction.

I recently, July 2011, had a sesamoidectomy. I was tired of: not being able to exercise, taking NSAIDS, cortisone shots and steroids to minimize the swelling. I must tell you that the anxiety will not be over immediately.
I still have not made a pre sesamoid pain recovery and based on my colleagues experience, that will mostly likely continue for a year.

What I'm saying is, once you're recovered you will be much more elated than you are now. You will have most likely taken a step to a sustained partial recovery. And that is something great, but don't expect a miracle. Stay realistic.

Both my tibial and fibular sesamoids in my right foot were causing me swelling. The fibular sesamoid was determined by x-ray to be broken, the tibial fractured. The tibial was removed. After 5 months I feel much better than I did pre-op. I continue to take NSAIDs, expect that. I wear orthopedic sandals, tevas and running shoes (that I've gotten refitted. Make sure you invest in a pair that will work well with your orthotics.) On occasion I grant myself a night with a pair of kitten heals, but I prepare for the aching the next morning.

I sometimes experience phantom itching at the incision site (strange I know) and the site hurts most when it is chilly.

I hope that helps. Mentally prepare for the surgery and don't let yourself get too nervous.

 
Old 12-03-2011, 06:19 AM   #6
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Hi Range00, I just had a fibial sesmoidectomy on Oct 6. I also had 2 previous surgeries before tht (bunionectomy and big toe fusion). I am still in pain and the doc wants me to have orthotics made which I go for next week. I am a little over 8 weeks post op. The doc said swelling may be an issue still to cause me pain. I am also wearing a comprehension stocking. Does this sound right to you? I am very discouraged. I still can't walk or stand without great pain. Anyone else with an insight to sesmoidectomies and recovery time? I had the incision on the bottom of the foot and was NWB for 6 weeks.

 
Old 12-03-2011, 01:27 PM   #7
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Hi Range00, I just had a fibial sesmoidectomy on Oct 6. I also had 2 previous surgeries before tht (bunionectomy and big toe fusion). I am still in pain and the doc wants me to have orthotics made which I go for next week. I am a little over 8 weeks post op. The doc said swelling may be an issue still to cause me pain. I am also wearing a comprehension stocking. Does this sound right to you? I am very discouraged. I still can't walk or stand without great pain. Anyone else with an insight to sesmoidectomies and recovery time? I had the incision on the bottom of the foot and was NWB for 6 weeks.

Hi Chubstercat:

I would tell you that everyone heals on their own time. Wearing compression stockings sounds like a good technique. If it works for you and you doctor steroids may work for you even better. I'm sorry to hear that you can't stand yet without great pain but don't get discouraged. Its that kind of attitude that takes us longer to get better.

Have you thought about a post-op sandal that takes the pressure off that location? It looks relatively normal and allows you to go on walks.
I also recommend exercises like the can roll have really helped my aching foot.

Last edited by moderator2; 12-03-2011 at 02:10 PM. Reason: please do not post a commercial website, for any reason.

 
Old 12-03-2011, 03:14 PM   #8
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Hi Chubstercat:

I would tell you that everyone heals on their own time. Wearing compression stockings sounds like a good technique. If it works for you and you doctor steroids may work for you even better. I'm sorry to hear that you can't stand yet without great pain but don't get discouraged. Its that kind of attitude that takes us longer to get better.

Have you thought about a post-op sandal that takes the pressure off that location? It looks relatively normal and allows you to go on walks.
I also recommend exercises like the can roll have really helped my aching foot.[/QUOTE]
Hi, thanks for responding - joy - I had the wrong person. I just don't know if this is "normal" and just takes a while or the surgery did not work. I already had 2 surgeries on this foot and all the hardware removed. I have been thru hell. Just was wondering what other peoples experiences were with sesamoidectomies. (mine taken out was the fibial). I just feel absolutly no improvement and feel by 8 weeks, I should feel at least some improvement.

 
Old 01-29-2012, 10:03 AM   #9
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Re: Chronic sesamoiditis - finally offered sesamoidectomy.

Quote:
Originally Posted by joy0065 View Post
Congratulations on the scheduling of your sesamoidectomy.

I would say it is definitely a step in the correct direction.

I recently, July 2011, had a sesamoidectomy. I was tired of: not being able to exercise, taking NSAIDS, cortisone shots and steroids to minimize the swelling. I must tell you that the anxiety will not be over immediately.
I still have not made a pre sesamoid pain recovery and based on my colleagues experience, that will mostly likely continue for a year.

What I'm saying is, once you're recovered you will be much more elated than you are now. You will have most likely taken a step to a sustained partial recovery. And that is something great, but don't expect a miracle. Stay realistic.

Both my tibial and fibular sesamoids in my right foot were causing me swelling. The fibular sesamoid was determined by x-ray to be broken, the tibial fractured. The tibial was removed. After 5 months I feel much better than I did pre-op. I continue to take NSAIDs, expect that. I wear orthopedic sandals, tevas and running shoes (that I've gotten refitted. Make sure you invest in a pair that will work well with your orthotics.) On occasion I grant myself a night with a pair of kitten heals, but I prepare for the aching the next morning.

I sometimes experience phantom itching at the incision site (strange I know) and the site hurts most when it is chilly.

I hope that helps. Mentally prepare for the surgery and don't let yourself get too nervous.
Are we allowed to mention who did surgery? When I see post from members stating successful surgies, I never see a quote of a doctors name. I've been looking for some time now and would love to know who did your surgery if you can share. Thanks

 
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