Cheilectomy Overview

Cheilectomy Overview

A cheilectomy is a surgical procedure to remove a bony lump (made up of bone spurs) on the top of the big toe's main joint.

Bone spurs are almost always caused by degenerative arthritis of the big toe (sometimes known as "Hallux Rigidus"). An injury to the cartilage covering the end of the big toe sometimes sets off the degenerative motion and eventually leads to Hallux Rigidus.

Why would someone have a cheilectomy done?

This operation treats degenerative arthritis, which occurs when bony spurs press painfully on the shoe. Bone spurs form around the joint as part of the degenerative process. They may restrict the joint's motion, especially the toe's ability to bend upward when the foot moves forward.

What is degenerative arthritis?

Degenerative arthritis is a breakdown of the joints in the body, wearing away the joint and the connective tissue around it. While the cause of most forms of arthritis is unknown, three significant factors play a role: heredity, lifestyle, and environmental factors such as overuse and/or a traumatic injury.

Who is at risk for degenerative arthritis and would be most likely to get a cheilectomy

Athletes, both amateur and professional, are at risk for degenerative arthritis. Because more young people get involved in contact sports such as soccer and rugby at an early age, more children are developing arthritic conditions. "Young people often do not realize that they injured themselves while playing sports," says Noreen Oswell, DPM, a podiatric surgeon in private practice in Los Angeles, Calif. "Years later, that injury results in a painful, arthritic joint. Arthritis frequently affects the feet and ankles," continues Dr. Oswell, "including the big toe joint, the ankle and the area under it, and the area under the arch." Cheilectomy can prolong the active lifestyle of athletes.

What does a cheilectomy involve?

The surgeon cuts the top of the big toe joint over the spurs and removes them so they will not bump together when the toe extends. This allows the toe to bend better and reduces the amount of pain when walking. Sometimes, the surgeon will remove a little extra bone to ensure that nothing rubs when the toe bends upward. The surgeon then flushes out the joint, stitches it up the incision, and applies a dressing. The cheilectomy takes about 20-30 minutes and is most often performed as an outpatient procedure under either local or general anesthesia. Most people with a cheilectomy can go home the same day.

What is recovery like?

The foot is bandaged, and patients are encouraged to stretch the big toe the day after surgery gently. As the toe heals, patients should slowly increase the movement of the toe. Patients return for a checkup 1-2 weeks after surgery and begin gentle exercises. Patients will typically be seen again 6-8 weeks after surgery. After a cheilectomy has been performed, bone spurs will rarely grow back. If the patient received the cheilectomy because of arthritis, there will most likely be an improvement in the arthritic pain within one month, and movement in the joint will increase.