Cheilectomy

Author
Discussion

funbobby

Original Poster:

1,626 posts

258 months

Thursday 10th June 2021
quotequote all
anyone here had this done? thinking i really need to get this done but being self employed taking to much time off is difficult so wondering whats peoples experiences/success of having this done was like?

sawman

4,919 posts

230 months

Thursday 10th June 2021
quotequote all
havent had it done but have done lots.

can be extremely effective and improve big toe pain for many years or can be extremely disappointing with further surgery needed.

Getting the joint moving again after surgery is really important in maximising benefit, (really) good rest for the first couple of weeks pays dividends down the road

hajaba123

1,304 posts

175 months

Thursday 10th June 2021
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Had both of mine done in my mid 20s, 46 now and all been fine, played rugby to a decent standard. Needed to keep on top of my foot and ankle mobility to remind them that they now bend!

NorthDave

2,366 posts

232 months

Friday 11th June 2021
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I had mine done maybe 4 or 5 years ago. I only had it done as I had a big bunion on the side of the foot and when I went for it looked at the consultant told me my toe had limited movement and was arthiritic.

It hurt for quite a long time after, around 3 years and has only stopped recently. In retrospect I should not have had it done as it wasn't causing me any issues as such.

funbobby

Original Poster:

1,626 posts

258 months

Friday 11th June 2021
quotequote all
Mine is giving me some grief when I walk so something needs doing at some point unfortunately. To those that have done it when we’re you able to walk and drive again? I understand it’s a quicker recovery than a full fusion? I’m tempted to try a cortisone injection but feel it’s just masking the problem really.
Sawman, you have done these procedures then? Sounds like sometimes it doesn’t work out and more work is needed? Given I’ve lived with it for around 5 years I don’t want to make things even worse !

Edited by funbobby on Friday 11th June 09:13

CCCS

366 posts

227 months

Friday 11th June 2021
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I've got my annual consultation with my consultant rheumatologist on Monday.

I'm going to ask if he can refer me for the keyhole cheilectomy developed by David Redfern and colleague. The whole procedure sounds better in many ways when compared to the non keyhole version. Much quicker recovery time etc.

I walked for one and a half hours yesterday and was in pain for the last fifteen minutes.

funbobby

Original Poster:

1,626 posts

258 months

Friday 11th June 2021
quotequote all
I came across him when I did some research, wonder what costs are involved?

croyde

22,898 posts

230 months

Friday 11th June 2021
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I too have an arthritic big toe and dorsal bunion where bone has built up. Very restricted movement and impossible to wear nice shoes or boots. I always have to wear trainers.

I hike and walk but it's always painful and the toes and foot are swollen by the end of the day.

I've seen the keyhole surgery on YouTube where the surgeon fits a small drill or burr through an incision and wears away the excess bone and then pushes the pulp back through the incision like a zit.

Patient is apparently back on their feet very quickly.

I believe the NHS version is more invasive and you can be laid up for weeks.

sawman

4,919 posts

230 months

Friday 11th June 2021
quotequote all
funbobby said:
Mine is giving me some grief when I walk so something needs doing at some point unfortunately. To those that have done it when we’re you able to walk and drive again? I understand it’s a quicker recovery than a full fusion? I’m tempted to try a cortisone injection but feel it’s just masking the problem really.
Sawman, you have done these procedures then? Sounds like sometimes it doesn’t work out and more work is needed? Given I’ve lived with it for around 5 years I don’t want to make things even worse !

Edited by funbobby on Friday 11th June 09:13
Painful stiff big toe is a degenerative process. Cheilectomy will not reverse any degeneration that you have in the joint, although fortunately the worst degeneration is at the margins of the joint and associated with the new bone that has grown around the joint - resecting this (cheilectomy) is effective but the fact that the joint has had surgery can cause further degeneration. Getting the joint moving again is important (exercises). The cheilectomy preserves the joint(mainly) and means that if there are more problems later you havent burned any bridges. Other procedures like fusion or arthroplasty destroy the joint they are final but you are stuck if you dont like it because they are one way trips

Cheilectomy should have you back to work and driving in 4-6 weeks, fusion more like 8 weeks - sometimes they take months to settle

Cortisone shot can help but my experience is that if theres much degeneration seen on xray they are of limited benefit - wearing stiff soled shoes/ very supportive trainers is best non surgical treatment

sawman

4,919 posts

230 months

Friday 11th June 2021
quotequote all
croyde said:
I too have an arthritic big toe and dorsal bunion where bone has built up. Very restricted movement and impossible to wear nice shoes or boots. I always have to wear trainers.

I hike and walk but it's always painful and the toes and foot are swollen by the end of the day.

I've seen the keyhole surgery on YouTube where the surgeon fits a small drill or burr through an incision and wears away the excess bone and then pushes the pulp back through the incision like a zit.

Patient is apparently back on their feet very quickly.

I believe the NHS version is more invasive and you can be laid up for weeks.
MInimal incision surgery is available in the nhs in many areas, for cheilectomy it may promote slightly quicker recovery

funbobby

Original Poster:

1,626 posts

258 months

Friday 11th June 2021
quotequote all
Think the problem I have with mine was on the x Ray it showed the gap between the joint on my toe had closed up almost like it had started to fuse itself ? Problem is the X-ray was just before the first lockdown so I’m struggling to remember what the exact details were ! I do know if I’m in the wrong footwear it’s bloody painful.

sawman

4,919 posts

230 months

Friday 11th June 2021
quotequote all
funbobby said:
Think the problem I have with mine was on the x Ray it showed the gap between the joint on my toe had closed up almost like it had started to fuse itself ? Problem is the X-ray was just before the first lockdown so I’m struggling to remember what the exact details were ! I do know if I’m in the wrong footwear it’s bloody painful.
if you feel things have go worse in the 15+ months since your x ray, you should discuss with your surgeon - they way want to revise the plan.

good luck

funbobby

Original Poster:

1,626 posts

258 months

Friday 11th June 2021
quotequote all
Unfortunately never got past the X-ray stage as covid hit , it’s actually marginally better these days but I need to do something about it. Tempted just to pay for it myself as I would imagine the nhs now has a huge backlog forming.

sawman

4,919 posts

230 months

Friday 11th June 2021
quotequote all
Backlog depends where you are - we have more or less cleared backlog in my area, whilst i know some areas further south have barely got going again yet.

Gently but firmly mobilising the joint by hand and massage, possibly with anti inflamatory gel can actually be helpful keeping things going- i used to get people to do this back in the days of long waiting lists in the noughties - some folks did so well with it that they didnt need op!

Edited by sawman on Friday 11th June 21:44

funbobby

Original Poster:

1,626 posts

258 months

Saturday 12th June 2021
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Thanks sawman for your input. When I was young I would have never of imagined one toe giving so much grief !