28289 Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant

Name of the Procedure:

Hallux Rigidus Correction with Cheilectomy, Debridement, and Capsular Release of the First Metatarsophalangeal Joint; without Implant

Summary

This surgical procedure treats stiffness and pain in the big toe joint caused by arthritis. It involves removing bone spurs and cleaning out the joint to improve movement without using any implants.

Purpose

The medical condition or problem it addresses:

Hallux rigidus, a type of degenerative arthritis in the big toe joint.

The goals or expected outcomes of the procedure:

• Reduce pain and discomfort.
• Increase joint mobility and functionality.
• Delay or prevent the need for more invasive surgery.

Indications

Specific symptoms or conditions that warrant the procedure:

• Severe pain in the big toe joint, especially when walking.
• Noticeable swelling and stiffness in the joint.
• Bone spurs that restrict movement.

Patient criteria or factors that make the procedure appropriate:

• Non-surgical treatments like medication and physical therapy have not provided relief.
• X-rays showing bone spurs and joint degeneration.
• Patients must be generally healthy enough to undergo surgery and anesthesia.

Preparation

Pre-procedure instructions for the patient:

• Fasting: Do not eat or drink anything after midnight the night before surgery.
• Medication Adjustments: Inform the doctor about all medications; some may need to be stopped prior to surgery.

Any diagnostic tests or assessments required beforehand:

• X-rays or MRI of the affected foot.
• Blood tests to ensure the patient is fit for surgery.

Procedure Description

Detailed step-by-step explanation:

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A small incision is made over the first metatarsophalangeal joint.
3. Cheilectomy: Bone spurs around the joint are trimmed or removed.
4. Debridement: Any loose debris or damaged cartilage is cleaned out from the joint.
5. Capsular Release: The joint capsule is gently released to improve range of motion.
6. Closure: The incision is closed with sutures.

Tools, equipment, or technology used:

• Surgical scalpel and instruments.
• Specialized tools for trimming bone and removing debris.

Anesthesia or sedation details:

• General anesthesia (patient is asleep) or regional anesthesia (numbing of the foot).

Duration

The procedure typically takes around 1 to 1.5 hours.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic Surgeon or Podiatric Surgeon
• Surgical Nurse
• Anesthesiologist

Risks and Complications

Common and rare risks associated with the procedure:

• Infection
• Bleeding
• Blood clots
• Nerve damage

Possible complications and their management:

• Persistent pain or stiffness - might require physical therapy.
• Delayed healing - follow-up care and potential use of crutches or a boot.

Benefits

Expected benefits and how soon they might be realized:

• Pain relief within a few weeks.
• Improved joint function and mobility, typically noticeable after recovery.

Recovery

Post-procedure care and instructions:

• Keep the foot elevated and apply ice to reduce swelling.
• Use prescribed pain medications as directed.
• Avoid putting weight on the foot until advised by the surgeon.
• Wear a surgical boot or use crutches for a few weeks.

Expected recovery time and any restrictions or follow-up appointments:

• Full recovery may take 6 to 12 weeks.
• Follow-up appointments to monitor healing and remove sutures.

Alternatives

Other treatment options available:

• Conservative treatments like anti-inflammatory medications, orthotics, and physical therapy.
• Joint fusion or joint replacement surgery in more severe cases.

Pros and cons of alternatives compared to the described procedure:

• Conservative treatments are less invasive but may not provide long-term relief.
• More invasive surgeries carry higher risks but may offer more permanent solutions for advanced cases.

Patient Experience

What the patient might feel or experience during and after the procedure:

• Some discomfort and swelling initially after surgery.
• Pain management with medications.
• Progressive improvement in joint function and pain relief over the recovery period.