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What’s a Cheilectomy?

Did you know that the joint at the base of our big toe bears about 40% of our bodyweight when we move? It plays a significant role when we walk and run, and because of the weight it bears (literally), it’s prone to arthritis. This condition is called hallux rigidus (often referred to as “stiff big toe”) and it causes the joint to lose its range of motion. While a “stiff joint” may seem small, it actually can significantly alter our biomechanics and can cause pain and difficulty walking and running. While non-surgical treatments such as medication, orthotics, and physical therapy can help in the early stages, more severe cases may require surgical intervention.

One such surgical procedure to treat hallux rigidus is a cheilectomy. This article will explore what a cheilectomy is, its benefits, risks, and the recovery process.

What is a cheilectomy

A side-by-side of two feet: on the left is the post-surgical foot with a surgical shoe. On the right is the equivalent surgical reference for where the surgery is done and the incision size.

cheilectomy is a surgical procedure that alleviates pain and restores motion in the big toe joint affected by hallux rigidus. This procedure removes bone spurs (osteophytes) and diseased tissue from the top of the metatarsal bone, which reduces pain and allows the joint to move more freely.

Cheilectomy: The procedure

A cheilectomy is usually done under local or general anaesthesia. The surgeon makes an incision over the top of the affected joint and then carefully removes the excess bone and tissue and smooths the joint surface. This frees up more space for joint movement. In some cases, the surgeon may do additional procedures, such as joint capsule release or cartilage repair, to improve the outcome.

Cheilectomy: The benefits

An aerial view of a bone spur above the first MTP joint (left foot, right of image).
  • Pain relief: A cheilectomy can significantly reduce pain and discomfort associated with hallux rigidus by eliminating bone spurs and diseased tissue.
  • Improved motion: The procedure frees up space around the big toe joint, which gives it more room to move around and restores the toe’s flexibility and range of motion. This makes walking, running, and other activities more comfortable.
  • Preservation of joint function: Unlike more invasive procedures like joint fusion, a cheilectomy aims to preserve the natural mechanics of the big toe joint, which helps maintain its function and stability.
The same foot with the bone spur above the first MTP joint removed.

Cheilectomy: Risks and considerations

While cheilectomy is generally considered safe and effective, like any surgical procedure, it carries certain risks. These include infection, bleeding and nerve damage. There are also many factors that can affect the outcome, such as the severity of the condition, age, and the patient’s overall foot health. If you’re considering a cheilectomy, it’s important to discuss the risks and the benefits with your healthcare provider so that you can manage your expectations properly assess with a cheilectomy is right for you.

Cheilectomy: What’s the recovery?

Following a cheilectomy, it’s normal to experience discomfort and swelling. You can manage this with pain medication and elevation. You’ll also need to do physiotherapy during the recovery process to restore the strength and flexibility in the toe joint.

Most patients are fully weight-bearing immediately after the surgery, and can usually return to light activities within a few weeks; however full recovery takes several months. Stitches are typically removed 2 weeks after the procedure. It’s important to follow post-operative instructions from the surgeon and to attend routine follow-up appointments to monitor the progress.

Prioritize your foot health at Feet First Clinic

Your journey to improved foot health starts with knowledge and proactive care. Feet First Clinic offers many solutions if you’re noticing pain in your big toe joint, such as orthopaedic footwear, footwear modifications, over-the-counter insoles and custom orthotics. To see what’s causing your foot pain, call to book a foot assessment or book an appointment online!

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Carolina Charles

Patient Relation Coordinator (She/Her)

If you’ve been to the clinic before, chances are you had the pleasure of meeting Carolina! Carolina’s daily goal is going above and beyond to make sure patients are always completely satisfied. Having worked in the podiatry industry for 22 years, Carolina brings a wealth of knowledge pertaining to client service, insurance policies, and procedures.​ She steers the ship to make sure everything runs smoothly on the daily. Carolina is known for spicing up every outfit with her signature costume jewellery.