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Foot & Ankle Problems Message Board


Foot & Ankle Problems Board Index


I had a titamium implant in the big toe joint as the cartiledge has goneabout a year ago. Had problems with my balance when I wuld lean off on that foot. I have almost constant "ache" on the outside of the toe, feels like pinching a muscle. Went back to dr. who Xrayed it and now there is a cyst in the big toe bone that was not there before. It swells, it aches and now she wants to remove the implant.
I am very nervous about yet more surgery. I had a bunion removed twice on my other foot and it seems like it may be returning again. On the implant foot- I had a "hammer toe" and she remove the joint in the toe-the one next to the big toe.
Any one had an implant removed in the big toe and then there is no joint? Does it just flop around? How about balance? Would it help the outside of toe ache? It seems to be worse after I have been walking and sitting-like driving a car. If I can reposition the foot-elevate it-helps.
I had hallux limitus or hallux rigidus treated conservatively for years but finally had to opt for surgery. A lot of research went into my decision making. Fusion of a joint essentially eliminates the joint. Pain in the joint is relieved as the joint is not there. The problem is that one's gait is altered considerably after fusion. The best option is to pick a procedure which attempts to restore function as close as possible to the manner in which the joint is designed.

If there is not adequate cartilage in the joint, then an implant is needed. That is true for hip joint and knee joints...not just the big toe joint. The problem with implants which resurface only one side of the big toe joint is that such procedures require good cartilage on the side of the joint which is not replaced. More often than not, both sides are worn.

I had both big toe joints replaced with an implant known as the "Primus" total big toe joint implant which is a flexible hinge. My foot surgeon, a board certified podiatric surgeon, allowed me to walk the next day, albeit in a limited fashion; back in running shoes in three weeks and actually running 3 miles per day in 5 weeks. Fusions take up to three months to heal and there was no way I could be slowed down that long.

Orthopedic surgeons I consulted favored the fusion approach. The big difference between the orthopedic and podiatry approach is that the podiatrists are trained in biomechanics, that is function of the foot and try to restore normal function to the greatest extent possible.





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