Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant
CPT4 code
Name of the Procedure:
Hallux Rigidus Correction with Cheilectomy, Debridement, and Capsular Release of the First Metatarsophalangeal Joint with Implant
Summary
This surgical procedure aims to relieve pain and restore function in the big toe joint (first metatarsophalangeal joint) by removing bone spurs, cleaning the joint, releasing tight structures, and sometimes placing an implant.
Purpose
The procedure addresses hallux rigidus, a form of degenerative arthritis affecting the big toe. The goals are to alleviate pain, improve joint mobility, and enhance overall foot function, potentially using an implant to replace damaged joint surfaces.
Indications
- Persistent pain in the big toe joint
- Limited range of motion in the first metatarsophalangeal joint
- Swelling and inflammation unresponsive to conservative treatments
- Difficulty walking or engaging in daily activities due to joint stiffness
Preparation
- Fasting for at least 8 hours prior to surgery
- Adjustments in medications as directed by the healthcare provider
- Pre-operative imaging (X-ray, MRI) to assess joint damage
- Pre-surgical physical examination and medical clearance
Procedure Description
- Anesthesia: Administered regional or general anesthesia.
- Incision: A small incision is made over the big toe joint.
- Cheilectomy: Removal of bone spurs that impede joint movement.
- Debridement: Cleaning out loose cartilage or bone fragments within the joint.
- Capsular Release: Cutting tight joint capsule structures to increase mobility.
- Implant: Placement of a prosthetic if needed to replace damaged parts of the joint.
- Closure: Suturing the incision and applying sterile dressings.
Duration
Typically, the procedure takes about 1 to 2 hours.
Setting
The procedure is usually performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic foot and ankle surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologist
Risks and Complications
- Infection
- Nerve damage
- Blood clots
- Persistent pain or stiffness
- Implant-related issues (e.g., loosening or failure)
- Delayed wound healing
Benefits
- Pain relief
- Improved range of motion and function of the big toe
- Enhanced ability to walk and perform daily activities
- Improved quality of life
Recovery
- Initial rest and elevation of the foot
- Compression dressings and/or use of a special boot
- Gradual return to weight-bearing activities
- Physical therapy to restore strength and motion
- Full recovery typically takes several weeks to a few months
Alternatives
- Non-surgical treatments (e.g., orthotics, medication, physical therapy)
- Joint fusion (arthrodesis)
- Joint resurfacing
- Each alternative has its own advantages and disadvantages regarding recovery time, durability, and preservation of joint mobility.
Patient Experience
During the procedure, the patient will be under anesthesia and not feel pain. Post-operatively, there might be mild to moderate pain managed with prescribed medications. Swelling and restricted activity are expected initially, with follow-up appointments to monitor healing progress.