Joint stiffness, pain or tenderness, swelling and/or redness that persists for more than two weeks—all may signal arthritis. Any of 100 forms of arthritis can damage our bodies, especially the joints, gradually wearing away protective cartilage where the bones meet to make a joint. The force our body weight generates on the toe and ankle joints makes them particularly susceptible to arthritis.

As cartilage erodes and bone rubs against bone, the joint becomes painful. Movement may become limited as bone ends erode or thicken, sometimes developing painful outgrowths, or spurs. If left untreated, damage to cartilage can seriously weaken the joints, often leading to pain and deformities.

About Arthritis

Rheumatoid arthritis and osteoarthritis are two common forms of arthritis that affect millions of Americans, especially those over age 45. The cause of rheumatoid arthritis, a 'systemic' disease that can affect the entire body, is unclear. It is believed to result when the body produces enzymes that inflame the joints and other tissues.

Osteoarthritis, sometimes called degenerative arthritis, or referred to as joint "wear and tear," is isolated to the joints. Pain and stiffness caused by cartilage destruction develop slowly as a result of years of everyday living.

Surgery When Joint Problems are Severe

Surgery to reconstruct the joint may be needed if arthritis causes chronic problems that cannot be controlled by medications, orthotics or physical therapy, especially if: pain is constant toe motion is limited, causing a change in natural stance or walk deformities (such as bunions and hammertoes) restrict normal activities In the vast majority of cases, reconstructive surgery can bring improvement. Pain relief is a common benefit. Other benefits may include an improved ability to move the joint, or an improved appearance. Goals of surgery are different for each individual, and should be discussed with the podiatric surgeon.

While surgical care will not cure arthritis or completely restore the joint to its natural health, it will ease pain and make daily activities more manageable.

Fusion or arthrodesis relieves pain by uniting the bones of the joint into a permanent, yet useful position, preventing any motion at the site.

The joint may require a complete reconstruction or resection arthroplasty. Here, the podiatric surgeon removes the bone ends at the joint, corrects tendons and ligaments that may have stretched as a result of arthritis, and replaces the joint with an implant (prosthetic joint).

Two of these surgeries, fusion and implant reconstruction, are described in greater detail in "About Your Foot Surgery."

Implants and Foot Surgery

The choice to use an implant is made carefully, only after the podiatric surgeon has decided that another type of surgery would not provide as many benefits.

Implants made from silicone rubber, polyethylene (a form of plastic), or titanium (see "implant Types and Materials") are quite safe. Like other artificial body parts, implants used in the foot have been evaluated by the Food and Drug Administration (FDA).

Implants for Pain Relief and Support

The narrow space separating the two bones of the joint permits movement. An implant's primary purpose is to maintain this joint space and support the toe. Because the implant replaces damaged or diseased bone and the bone's cartilage, it keeps the toe at an appropriate length. Without an implant, the toe may appear shorter.

The implant helps eliminate pain, and provides stability to the previously weakened joint. A secondary purpose of an implant is to permit the toe to bend and function more freely.

As the joint heals, new tissue forms around the implant, making the joint stable and the reconstruction more durable.

About Your Foot Surgery

Surgery usually requires only one to two hours. It is often completed on an outpatient basis, but a short hospital stay of one or two days is not unusual.

Implant Reconstruction

The podiatric surgeon will expose the damaged joint and carefully remove any inflamed tissue. A small portion of damaged bone also will be removed, and the bone ends smoothed.

Implants with a single stem, made from either silicone rubber or titanium, may be used in the base joint of the big toe to treat a bunion, bone spur or toe stiffness and pain. This implant is most effective when only one side of the joint is damaged.

Schedule an appointment to visit with Aloha Foot and Ankle Associates, Inc. to determine which treatment is likely to be the most successful in your case.