I was diagnosed with Hallux Rigidus (painful big toe joint with limited
movement) and had surgery to remove bone spurs and “clean up the joint a
year ago. It never did stop the pain & it hurts worse than ever now.

The Podiatrist that did the surgery now recommends an implant called a
“Hemi”. Frankly he didn’t sound that convincing that it would fix my
problem.

I went to an Orthopedic surgeon today for a second opinion. Well the
surgeon says the best way to go is to fuse the joint together using
screws & a metal plate. He does not do toe joint implants and does not
recommend it either. He says there are too many problems with the
procedure that my Podiatrist recommended. He claims there are 7 or 8
other orthopedic surgeons that specialize in foot and ankles in this
area and that none of them will do that implant procedure. He claims he
has done "literally hundreds" of the fusion procedure and the success
rate is very high. The Podiatrist has done only 25 “Hemi” procedures
over 8 years… He says that it shouldnt affect my walking "much".

My questions are…

1.How much will the fused big toe joint affect my mobility? Will I limp?
Frankly I limp a little now with the sore joint! I am male, 49 years old
and fairly active, I would be more so if my toe didn’t hurt all the
time.

2. Does the fusion get rid of all of the pain?

3. Does anyone have any experience with the Hemi implant? Good, bad?

I would appreciate any input any of you might have…

Thanks in advance!

Ted,

I had to have all of the toe joints on my left foot fused over ten years
ago and I do not experience pain in them and it has never thrown me off
balance or affected my gait.

Don Whitely

Hi Ted,
Let me start by saying I don't know what a "Hemi" is. I've had a Partial
joint replacement in my L big toe. Why they didn't replace the entire joint
I don't know. I guess it was the "current knowledge" thing. Docs recently
have told me "oh you had one of those" and "they don't do that procedure
anymore". What has happened is the joint swelled to about 3x's normal size
and stayed that way.......forever. Have a hell of a time finding shoes as I
can't have any pressure on the joint without severe pain. This was done
around 10 yrs ago now. Arthritis has pretty much fused the joint so they see
no point in fusing it with devices. Problem is, it isn't 100% fused and
occaisionally I get "over the top of the toe" as I call it and the joint
moves "too far". Extremely painful and then very sore for the next few days.
I can't recommend what to do in your case, but if you go for the joint
replacement make sure they replace the entire joint and not half of it.
GaryZ

"Ted" <txguy972@aol.com> wrote in message news:43D175C1.9109E279@aol.com...

"Ted" <txguy972@aol.com> schreef in bericht
news:43D175C1.9109E279@aol.com...
run...It is called an arthrodesis.

I have no more pain. My toes are pain free. Because off the fusion the joint
can not move ....and that mains : no more pain.
NO

Thanks all, you helped me decide on the fusion or "arthrodesis". The
implanted partial joint replacement sounds like asking for trouble down the
line...

Ted

Ted wrote:

Thanks all, you helped me decide on the fusion or "arthrodesis". The
implanted partial joint replacement sounds like asking for trouble down the
line...

Ted

Ted wrote:

Thanks all, you helped me decide on the fusion or "arthrodesis". The
implanted partial joint replacement sounds like asking for trouble down the
line...

Ted

Ted wrote:

Hello Ted (and others),

I think I know what you're talking about (the "hemi, I mean). The
procedure is called "arthroplasty", and I just had one done last October
for Hallux Rigidus on my left foot. I have a metal implant in the
distal joint.

Thus far I have no regrets. I still have some swelling, but it is
diminishing. The ROM didn't come back on its own so I've just started
physiotherapy and am starting to feel things loosen up. Actually, my
entire foot needs physio; after 20+ years of deterioration due to
arthritis and walking strangely to accommodate the affected joint, all
of the bones in my foot are stiff and need some work. (FWIW, I'm 43
years old.)

The recovery for this procedure is generally 3-6 months. I have just
passed the 3 month mark and am confident of a good outcome. How
confident? I also have Hallux Rigidus in my right foot and am on the
waiting list for surgery in March. I plan to go ahead with it when I get
the call.

I can't say that I'm pain free yet, but I don't expect to be.
Occasionally I feel a twinge in the joint where I had the surgery, but
it's nothing like the severe pain in the other joint that hasn't been
done yet.

Finally, my surgery was not performed by a podiatrist. I am being
treated by a very fine orthopaedic surgeon in Toronto.

Just another point of view.

Kind regards,
Maureen in Toronto (who was been lurking on ASA for a very long time)

GARY Z wrote:

On Mon, 23 Jan 2006 13:36:15 GMT, Maureen Morin
<maureen.morin@NOSPAMutoronto.ca> wrote:

What a pansie! A real man/runner, would run through a minor injury
like this.

Hi Maureen,
I'm very glad to of your successful outcome with your procedure! Perhaps I'm
just one of the "weird" ones for whom it didn't take.
No comments from the peanut gallery now :-)
GaryZ

"Maureen Morin" <maureen.morin@NOSPAMutoronto.ca> wrote in message
news:ItJsMA.6zt@campus-news-reading.utoronto.ca...

On Mon, 23 Jan 2006 11:14:29 -0600, "Gary Z"
<dadandone@N_O_S_P_A_Mverizon.net> wrote:

Don't worry, you can still lead a meanigful life as a sexless freek.
You can deliver papers. It's at night, so nobody'd see you.

Hi Gary,
I'm sorry that your procedure didn't work out. And I sympathize about
the shoe issue. With an oversized joint and ROM issues shopping for any
kind of footwear that doesn't press down in the wrong places can be a
really frustrating experience. These days I mostly wear two-strap
Birkenstocks, but am looking forward to something a bit more stylish
once I've recovered from both surgeries.

Regarding your current situation, would pursuing fusion with another
surgeon be possible? I don't believe in putting up with pain needlessly
when there are alternatives. And even if the joint has almost fused on
its own, there could be many painful years before it decides to stop
moving without surgical intervention.

Cheers,
Maureen (in Toronto where the weather is sunny but the political
forecast is not :-( )

Gary Z wrote:

Hi again Maureen,
I am going to see a different podiatrist (old one left the hmo) as I'm
having some trouble with plantar facitis (?) these days and don't want to
wait too long to address it. I will see what his recommendation is for that
foot.
GaryZ

"Maureen Morin" <maureen.morin@NOSPAMutoronto.ca> wrote in message
news:ItK7t3.4ps@campus-news-reading.utoronto.ca...

Hi Gary,

I hope you find some relief after you see your new podiatrist.

I'm a bit curious about something, though. Why a podiatrist rather than
an orthopaedic surgeon? I thought that all bone surgery was done by
orthopaedic surgeons, but perhaps I'm mistaken.

Finally, my physiotherapist said something interesting to me last week.
She said that if you want to find out who the good surgeons are, ask a
physiotherapist. They see all the patients who need help post surgery,
and learn pretty quickly who is skilled and who is not.

Cheers,
Maureen (in Toronto, where we are now blue in more ways than one :-( )

Gary Z wrote:

Hi Maureen,
The podiatrist did both the implant on my left foot and the bunionectomy on
my right.
He actually did the bunionectomy in his office suite (little surgical room).
That is a long story in itself though!
:-)
GaryZ

"Maureen Morin" <maureen.morin@NOSPAMutoronto.ca> wrote in message
news:ItLnqE.1LA@campus-news-reading.utoronto.ca...

I have done hemi implants for srthritic stiff big to ejoints and have had
great success with them. I was using a silastic(silicone) type of total
joint implant with good success but have switched over to a partial joint
(hemi) type implant made of steel and chrome plating.
The range of motion is wonderful without joint pain. Frankly I have done
fusions also but considering your age and wanting to get more activity, I
would hesitate to do a fusion type procedure.
The hemis will probaly work fine and you could always have the fusion at
some time in the future if needed. Once the fusion is accomplished, there is
no going back.

Dr. BOB
"Ted" <txguy972@aol.com> wrote in message news:43D175C1.9109E279@aol.com...

"footdoc" <footdoc2890@hotmail.com> wrote in message
news:uLxBf.102911$XJ5.41505@twister.nyroc.rr.com.. .
So any idea why my partial implant swelled and stayed that way for 10 yrs
now?
GaryZ

On Wed, 25 Jan 2006 07:44:37 -0600, "Gary Z"
<dadandone@N_O_S_P_A_Mverizon.net> wrote:

Yes Gary, as we told you in the office, until you cut back your
"over-active" masturbation schedule (Viagra or not, 70 or 80x a day is
just too much) at least in half. You "squeezed off" a couple during
the MRI, and the nurses did NOT appreciate it.

Dr BOB

Are you a Podiatrist? It seems that Orthopedic Surgeons that specialize in
ankles and feet think that the implants are unreliable. Why the difference in
opinions? The Ortho guys have quite a bit more education don't they?

You say "Frankly I have done fusions also but considering your age and wanting
to get more activity, I would hesitate to do a fusion type procedure."

Just how much would the fusion affect my activities in your opinion? My research
shows that it shouldn't be much...

You say "The range of motion is wonderful without joint pain."

So you are saying that there would be no pain? How can you say that considering
you are only replacing half of a joint where the cartilage is ALL gone? My
Podiatrist says that some people have pain still after the implant. That's why I
am going to have the fusion unless I see some pretty compelling evidence that
the implants are reliable.

Isn't it also true that the implants sometimes fail as soon as a year after
being put in? What is the life span of a Hemi implant in your opinion?

Is there anyone here that has had an implant that was successful (no pain) long
term? I mean 5+ years?

Thanks all... (except for the smart ass thats lurking here)

footdoc wrote:

On Wed, 25 Jan 2006 19:08:48 GMT, Ted <txguy972@aol.com> wrote:

Hey pal, we got enough perversions without you taking this subject
here. If you want to ask people if they are peds, take it to
alt.pedophilia.something.