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Old 07-09-2012, 11:29 AM   #1
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large toe implants

This is my first time posting and having read as many of the previous discussions on great toe implants, it seems that no one has a success story. I had a titanium implant placed in Dec 2011 and it was very painful from the start. At the end of Feb, I was released to full activity. It was still painful but I thought it would improve. I am an active 57 year old hiker who was having some toe pain but began experiencing hip and periformis issues due to changes in gait. I wanted to do the best I could to preserve my activity level and now am reduced to hobbling short distances The Podiatrist I saw stated that he thought he was only going to do a decompression osteotomy as it wasn't that painful but said there was no cartilage there when he went in hence the joint replacement. Now he is suggesting a silicon implant and I'm horrified when I read the posts. I do have an appointment with an Orthopedic Foot and Ankle Doc about 4 hours away from the rural place I live in CO but as asked in other posts; does anyone have anything positive to say about joint replacement? Thanks in advance.

 
Old 07-09-2012, 06:25 PM   #2
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Re: large toe implants

I'm sorry that you've gone thru this. A sports med ortho who is foot and ankle board certified is your best bet. Joint replacements have a high failure rate. There are a couple of alternatives at your point in time - fusion or joint resurfacing. The resurfacing is a rather new procedure but is similar to hip or knee resurfacing, both of which have been done for some time.

Keep us posted on your progress.

 
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Old 07-10-2012, 06:26 AM   #3
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Re: large toe implants

Thank you, the resurfacing is something I haven't heard of and I'll look further into it. The fusion is just seems so drastic and I worry about it affecting gait.

 
Old 07-10-2012, 08:18 AM   #4
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Re: large toe implants

No need to worry about that as it won't impact your gait. They fuse it at an angle so that you can roll off it as normal. You can dance, work out, jog, hike, do lunges, etc. You can even wear low heels.

 
Old 07-11-2012, 10:54 AM   #5
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Re: large toe implants

That is good to know. I have other concerns with the fusion as I may not tolerate titanium very well. I had to have screws removed from my shoulder from a fracture repair after 11 months as I wasn't tolerating them although that may have been due to impingement. I guess I'll know more after the Ortho consult. Once again thank you for the good info on the fusion. It was great to hear that gait was unaffected.

 
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Old 07-26-2012, 06:15 AM   #6
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Re: large toe implants

Quote:
Originally Posted by titanCO View Post
This is my first time posting and having read as many of the previous discussions on great toe implants, it seems that no one has a success story. I had a titanium implant placed in Dec 2011 and it was very painful from the start. At the end of Feb, I was released to full activity. It was still painful but I thought it would improve. I am an active 57 year old hiker who was having some toe pain but began experiencing hip and periformis issues due to changes in gait. I wanted to do the best I could to preserve my activity level and now am reduced to hobbling short distances The Podiatrist I saw stated that he thought he was only going to do a decompression osteotomy as it wasn't that painful but said there was no cartilage there when he went in hence the joint replacement. Now he is suggesting a silicon implant and I'm horrified when I read the posts. I do have an appointment with an Orthopedic Foot and Ankle Doc about 4 hours away from the rural place I live in CO but as asked in other posts; does anyone have anything positive to say about joint replacement? Thanks in advance.

 
Old 07-26-2012, 06:20 AM   #7
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Re: large toe implants

I had a great toe and second toe fusion in Jan 2012. I was 100% compliant for the required 8 woks of non weight bearing. Unfortunately, there was absolutely no bone fusion. None. Now two of the three titanium screws have broken in half. I have no choice but to have them removed and have implants. Needless to say, my foot is painful and now my hip and knee are being affected by my impaired gait. My podiatrist says only 2% of population does not fuse and I happen to. Be in that group. I am very concerned about yet another procedure. This was supposed to be over in 8 weeks and it is approaching 8 months with no end in site.

 
Old 07-26-2012, 06:54 AM   #8
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Re: large toe implants

Perhaps you need a foot and ankle board certified ortho instead of a podiatrist. I highly recommend that.

 
Old 07-26-2012, 08:09 AM   #9
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Re: large toe implants

Thanks, I do have an appt with a Board Certified Foot and Ankle Ortho scheduled for next week.

 
Old 07-26-2012, 03:00 PM   #10
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Re: large toe implants

I had my big toe fused in October 2009. I have a plate and screws system. I was able to heal weight bear as tolerated from the beginning, and then use my full at six weeks. It did not seem to be fusing at first, and I don't know what the status is with that now almost three years later. It doesn't really matter though, because it is solid, and causes no problems.

I was very afraid of having that joint fused. The idea of a motionless joint freaked me out. Frankly though, I needn't have worried. The joint already had a significantly reduced range of motion, and it was very painful. My gait had been altered because I was compensating for the pain. Now that that joint has been fused, it feels like I have more range of motion, ironically. I can walk with a normal gait, and have a wider selection of shoes I can wear. Unfortunately, my other ankle gets cranky if I go with little support, so I still wear Birkenstocks, running shoes, and similar. That is okay though, because my foot doesn't get sore in them anymore. I can wear my Dansko clogs again, and they have a heel of about an inch and a half.

I would only go with an orthopaedic surgeon, not a podiatrist. I say that as someone coming from a town that has a very good podiatrist. If I had elected to have the podiatrist do surgery, I think there would have been a different outcome, and an ultimate fusion anyway.

Last year I walked in a walk for women's cancers in Vancouver. I walked 60 kilometres in two days. I had the worst blisters I've ever had, but my toe handled it great.
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Old 07-27-2012, 07:18 AM   #11
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Re: large toe implants

It is great to hear about a positive outcome with fusion. I have been very afraid that I am looking at that but after reading your post I feel better - thanks. It has been interesting that after doing the research, most Orthos don't like the artificial joints due to a high failure rate while the podiatrists like them a little more. I wasn't expecting to get the artificial joint from the get go as the Podiatrists advised me he didn't think I would need that but stated when he opened the joint, there was no cartilage. One has to go forward from here so at least hearing other surgical outcomes helps.

May I ask did any of you have Vit D levels checked and were any of you low? Mine was clinically low at 17 and I wondered if that may have affected this outcome.

 
Old 07-27-2012, 07:42 AM   #12
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Re: large toe implants

titanCO, your question about vit D is interesting. I haven't had mine checked, but since I am in Canada, and currently northern Canada at that, they could very well be low. I learned recently that vit d and k combined help bone growth, and strength better than calcium. It would have been interesting to have seen if it would have helped post-surgery in particular. I had some osteoporosis in one bone post surgery, and that is common. Apparently it resolves once you start using the foot (or whichever bone) again.

Did you know that the implant would be a possibility? I would have thought there would have been a back-up plan in case there was no cartilege, and that you would have given your permission before surgery. My surgeon knew before the surgery that there was no cartilege left. I could even see that when I looked at the x-ray. There was no joint space at all.
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Old 07-28-2012, 11:17 AM   #13
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Re: large toe implants

I was advised and gave consent prior to surgery for the joint implant but it was a remote possibility according to the Doctor given that my pain wasn't severe. Consequently I didn't do the research that I should have and am now trying to proceed as informed and knowledgeable as possible. This Board has given me a lot of useful info and I'm grateful to all who have posted and responded.

 
Old 07-28-2012, 05:24 PM   #14
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Re: large toe implants

Quote:
Originally Posted by Titchou View Post
Perhaps you need a foot and ankle board certified ortho instead of a podiatrist. I highly recommend that.
I agree about finding an MD, but it isn't easy. I found one last week, 75 miles away, and the first available appt is in Oct! Does anyone reading this have experience with the HemiCAP implant?

 
Old 07-28-2012, 05:27 PM   #15
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Re: large toe implants

Quote:
Originally Posted by titanCO View Post
It is great to hear about a positive outcome with fusion. I have been very afraid that I am looking at that but after reading your post I feel better - thanks. It has been interesting that after doing the research, most Orthos don't like the artificial joints due to a high failure rate while the podiatrists like them a little more. I wasn't expecting to get the artificial joint from the get go as the Podiatrists advised me he didn't think I would need that but stated when he opened the joint, there was no cartilage. One has to go forward from here so at least hearing other surgical outcomes helps.

May I ask did any of you have Vit D levels checked and were any of you low? Mine was clinically low at 17 and I wondered if that may have affected this outcome.
Checking Vit D levels is a good idea I had not thought of. After 600 hrs of using a bone stimulator there is no fusion in my great toe. My podiatrist says about 2% of the population does not fuse, and I am in that group. Now I am looking at an implant but have great concerns after reading some of these posts. Any advice?

 
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