Cheilectomy To Treat MTP Joint Arthritis

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Image Credits: Footfiles 

What is the MTP Joint? 

The metatarsophalageal joints (MTP joints), are identified as the connection points between the phalanges (toe bones) and the metatarsal bones in the feet. Physical stresses can cause the joint alignment to shift, and induce ailments such as joint arthritis. There are five MTP joints on each foot, and in orthopaedics the “MTP Joint” is the term referring to the big toe joint, since it is the site primarily affected. The main MTP joint is critical to balance, and care must be taken in the instance of pain experienced in the area. When aggravated enough, the cartilage in the MTP joint can wear away, and generate bone spurs and joint arthritis. Acute therapy for MTP joint arthritis includes physical therapy. For severe conditions, surgery will be needed. This article will focus on the therapy known as a cheilectomy. 

What is a Cheilectomy? 

The cheilectomy procedure incorporates various steps in order to facilitate the restoration of the joint. Generated bone spurs are one of the primary objectives of the procedure. During arthritis, these bone spurs develop on the top of the big toe, creating a protrusion. When this occurs, there is a swelling of the joint, and the patient will experience pain in the region, and limited mobility. As a minimally invasive procedure, the cheilectomy will ensure that big toe mobility is restored. 

What Symptoms Do Patients Experience During MTP Joint Arthritis? 

MTP Joint Arthritis symptoms include: 

  1. Stiffness in the joint. Toes are designed to be flexed and pointed, and with joint arthritis, accomplishing this action will be difficult for the patient. 

  2. Pain induced by the stiffness of the joint and the presence of the bone spurs

  3. Cartilage Loss resulting in a minimized ability of the joint bones to smoothly coordinate during motion. The cartilage will change from a healthy thick white film to a yellow thin film. 

  4. Benign Bone Cysts that can develop in the periphery of the joint surface. 

Cheilectomy Surgery

Your surgeon will determine if you are a candidate, based on the severity of your condition. The more symptoms experienced is the higher the likelihood of you being a surgery candidate. The surgical steps involved in a cheilectomy may include elements of the following:

1.Arthroscopy of the mtp joint

2.synovectomy

3.debridement

4 minimally invasive correction of the great toe angle and insertion of screw

5.minimally invasive removal of bone spurs

With the procedure, the differing elements described above will facilitate the removal of the bone spurs. Mini-incisions are used with a specialized reamer tool to remove the bone spurs. A mini screw maybe inserted if correction of the great toe is required. These are closed with steri-strips.

Post Surgery Recovery Process

As a minimally invasive procedure, the procedure is completed under anaesthetic in less than one hour. Patients can return home on the same day, and can walk after surgery. Your surgeon will book your post-operation visit for your suture removal approximately two weeks after your procedure is completed. 

As a therapy that is quite effective, joint motion can be improved quickly. Talk to your orthopaedic surgeon today, if you feel that this minimally invasive procedure will be suitable for your MTP joint arthritis. 

Reference Article: 

  1. What Is A Chielectomy? : https://www.verywellhealth.com/cheilectomy-surgery-faq-1337652

  2. Arthroscopic treatment of focal osteochondral lesions of the first metatarsophalangeal joint: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406985/

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