Great toe arthritis is also known as hallux rigidus.  This form of arthritis usually develops over a number of years and results in pain while walking.  It can also lead to large spurs on the top of the big toe that make shoe wear painful.  Treatment options include anti-inflamatories and Tylenol.  Patients can also utilize wide, deep shoes and orthotics.  If conservative treatment fails surgery is an option.  The type of surgery varies depending on the severity of the arthritis.  For mild to moderate arthritis a debridement procedure, known as a cheilectomy, can be performed.  This procedure can also be used in cases of severe arthritis, when pain from the spur leads to difficulty with shoe wear.  Other surgical options include fusions, fascial interposition arthroplasty, and replacements.  The role of minimally invasive surgery has expanded to include minimally invasive cheilectomy.  This procedure is frequently performed in conjunction with an arthroscopic debridement of the great toe.  The minimally invasive nature of the surgery leads to less scaring, less post operative pain, and a more rapid recovery.

The patient in this example is an active gentleman , who presented with severe great toe pain and difficulty wearing closed shoes on both of his feet.  In addition, he complained of a painful bunion on the left foot.  He has undergone bilateral minimally invasive cheilectomies, which included a realignment fo the left great toe.  The video was taken approximately 6 weeks after surgery.