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  • Keller vs. Fusion

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    Old 10-06-2003, 07:22 AM   #1
    bunionman53
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    Red face Keller vs. Fusion

    Has anyone been frustrated with conflicting info on what to do with arthritic great toe joints on both feet? One has had 2 bunion surgeries, the other is painful but still a virgin. I'm an athlete at 53 who enjoys running, cycling, yoga and exercise classes. The foot problems probably developed from long-term overuse and now threaten to sideline me permanently. I have foot stiffness but retain 15-20 degree mobility on both toes. One doctor says Synvisc, one says Keller's the third says runners prefer fusion???

     
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    Old 10-12-2003, 05:42 AM   #2
    metatartus
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    Hi bunionman, I think maybe people don't know the term "Keller" or you would have had more responses. Check out the discussion of 9/23 under Hallux Limitus for lots of info on your problem. There are many of us who have posted on the dilemma of how to treat big toe arthritis. A gal name Sue has had good luck with fusion, which is heartening news given all the negative outcomes we see on this whole list for foot surgery. I have had a very painful right big toe joint for almost two years now; it's cut way into my hiking. But I have seen so many poor outcomes and gotten so much conflicting info that for the moment I'd rather stick with what I have--at least I know what pain to expect. I have been thru two podiatrists and one ortho. One pod recommended bunion surgery only; 9 months later he recommended a Keller, saying the flexibility would be better than a fusion (I think he forgot that he had earlier said I had a bunion--my ortho says it is NOT a bunion, just joint degration). The pod said othopods tend to do fusions, but he prefers Keller. He implied also that my ortho did fusions mainly on older people (I'm 59)--and suggested that Keller is for more active people. Well, I did lots of research on the net and found just the opposite was the case. The consensus seems to be that even tho it limits movement, fusion is the choice for runners and athletes. Implants tend to wear out with lots of use, so they are less of a choice for the very active. But I'm sure they are improving every day and will one day be the best option. As for Keller, many people end up with "too floppy" a joint, and this affects walking and running more negatively than the stiffness of a fusion (this is my overall impression from reading some of the studies on MedLine. I would be really interested in hearing the outcomes of people like yourself and some others on the 9/23 discussion who may be making a choice in the near future. I just chickened out of a Keller about a month ago after setting it up before I had done my own research. Now I'm pretty sure that my option would be fusion if I choose to have any surgery at all. I guess I am hoping against hope that maybe the toe will fuse enough on its own to stop the pain. I just don't like the idea of have screws and plates in my toe. Best of luck.

     
    Old 10-14-2003, 05:59 PM   #3
    bunionman53
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    Thank you for your comments. Sound like you have been through alot. Like you I've been suffering for a long time. The Podiatrists like the Keller, the Orthopods seem to want to be more creative and offset the joint. They think that even without cartlidge they can return the joint to near-normal. My Pods think the floppy toes will be pain free and the recovery time will be shorter. Furthermore they say that noncompetitive athletics will not be seriously impared by the Keller. I really wish they had an implant that can stand up to a little abuse. One Pod wants to stretch out the joint and infuse Synvisc before considering another operation. What do you think?

     
    Old 10-24-2003, 04:36 PM   #4
    metatartus
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    Sorry I haven't been checking the forum but time flies! I don't know what Synvisc is--would like to hear more about the procedure. It's interesting that the options we are presented with all seem to vary somewhat. I too can't imagine why the techies haven't come up with a workable, durable synthetic joint for the toe, given that hip and knee replacements are so common. Anyway, would like to hear more about Synvisc (do I have the name right?) and whether you have come to any conclusions. Also--do you by chance notice any worsening with certain kinds of foods? It's so hard to check on these variables since everything in one's routine changes, but I'm always looking for some option other than surgery. For the moment, I'm putting up with the pain and hoping my toe will heal on its own.

     
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