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Cheilectomy

Cheilectomy is an operation on the big toe joint; also known as the metatarsophalangeal (MTP) joint. During the procedure, a surgeon removes an extra bone or a bone spur from the joint.

Also known as: sometimes you might see a cheilectomy be referred to as a hallux rigidus treatment or a big toe cheilectomy

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Everything you need to know

Cheilectomy is an operation on the big toe joint; also known as the metatarsophalangeal (MTP) joint. During the procedure, a surgeon removes an extra bone or a bone spur from the joint. Sometimes these bone spurs arise in people who struggle with rheumatoid arthritis, or it can be used as a treatment for hallux rigidus.

A cheilectomy will be used in conjunction with toe mobilisation exercises and should relieve any big toe arthritis pain.

Before surgery

Before you decide on a big toe surgery, you’ll meet with our orthopaedic consultant. During this appointment you’ll discuss your medical history, evaluate your physical health, and may order tests, to assess whether this procedure is right for you.

The usual rules apply when you treat hallux rigidus or bone spurs with a surgical procedure. For example, our team might advise you not to eat or drink for 8 hours before your surgery, Try to stop any conflicting medicine (as advised by your doctor) when you’re waiting for your surgery and keep your body in as optimal health as possible.

During surgery

A general or local anaesthetic will be used when you undergo this surgery, depending on the previous discussion with your consultant.

Once the anaesthetic kicks in, the orthopaedic surgeon will make a cut on the side of your big toe. From here, they’ll remove any excess bone or bone spurs. Those are typically found on the top of the metatarsal bone or the base of the phalanx bone in the big toe. In addition to removing bone spurs, the surgeon may also smooth and reshape the joint surfaces to promote better movement and reduce friction within the joint. This should help relieve the pain that you were feeling.

From here, the doctors will carefully stitch up your toe, add any wound dressing, and take you to the post-operative room.

A cheilectomy is a minimally invasive procedure, so you should be able to go home once the anaesthetic wears off.

After the surgery

As you won’t be able to drive, ensure that you have arranged for someone to take you home that day.

After surgery, you may also be given additional tablets for pain relief. Immediately after the procedure, you won’t be able to wear your shoes, and you’ll need special footwear to protect your foot in the healing process.

For the first few weeks, make sure that you rest and elevate your foot as much as possible. Movement restriction will be key here and you won’t be able to perform usual activities. Although it might be difficult to limit movement, it’s important that you do, so that the main joint and incision site has time to repair.

Two weeks after surgery, you’ll need to get your stitches removed and fresh wound covered. At this time, if there is some mild swelling, muscle tightness, or concerns of nerve damage and blood clots, make sure you let your healthcare provider and doctor know.

Whether it’s ankle surgery or toe surgery, wound healing takes some time for most patients – sometimes up to a year. It’s important that in your follow-up appointment you’re as honest as possible. That way, your doctor can provide relief with more anti-inflammatory medication, other nonsurgical treatments, or physical therapists.

If all is well and you’re pain-free during your follow-up appointment, you’ll be able to slowly use your foot more. Perhaps you can wear normal shoes again, try more strenuous joint movement, and explore gently walking and putting weight on the foot.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.