The main goal of performing a Cheilectomy is to “clean-up” the arthritic joint of the big toe knuckle (1st MPJ). Often there are painful and prominent bone spurs that can be removed allowing for better shoegear fitting and overall increased comfort. If the cartilage damage inside the joint has “potholes”, these can be treated with drilling in order to stimulate the body to create a type of fibrocartilage or scar tissue to fill in the gaps. This type of surgery is good for a mild to moderately arthritic joint and is thought to “buy time” before the joint needs to be fused or replaced. It does not cure the existing joint damage brought on by the arthritis.
This type of surgery is done in an outpatient surgical facility with IV conscious sedation.
After surgery, walking is usually allowed immediately in a protective post-operative shoe or boot. This is used mostly to accommodate for the thick bandaging and to protect the incision. Skin sutures are removed 2 weeks after surgery. Once the sutures are removed, normal bathing of the foot is allowed.
Activity after surgery will be limited, and tenderness in the big toe joint can be expected. Sometimes the range-of-motion can be improved with this surgery, but isn’t expected to be dramatic. Your walking will be slowed down for several weeks. Impact-style activity like walking or running is allowed as soon as the sutures are removed, but usually isn’t completely comfortable until closer to 6-12 weeks post-op. Swelling of the foot is a common finding after surgery and can take anywhere from 6 weeks to 6 months to fully resolve.
Driving is allowed almost immediately if the surgery is LEFT-SIDED, and the car is an automatic. Driving for RIGHT-SIDED feet will take anywhere from 2-6 weeks, and will depend on the individual. It is not recommended to drive while wearing the post-op shoe. If the foot + bandages will fit inside a sandal or athletic shoe, then driving can occur within 3 days of surgery.
Appropriate long-term expectations from having your arthritic joint “cleaned-up” include better fitting inside shoegear, the potential for less nerve irritation, and less knuckle pain. Again, the joint is stiff going into surgery because of the joint damage and isn’t expected to necessarily be “less stiff” after surgery. Long term use of custom orthotics are known to slow down the joint damage occurring within the joint and is strongly recommended to be tried both before and after this type of surgery.