Big Toe Arthritis – Advancements in Treatments

Hallux Limitus & Hallux Rigidus: Arthritis of the Great Toe Joint

There has been a great deal of advancement in the treatment of great or big toe arthritis also known as hallux limitus or hallux ridigus.  The terms commonly used are referring to the latin for limited to no motion which is the main complaint that patients will have when they present to our office.  There is no clear understanding of the cause of hallux limitus/rigidus, but the main understanding is it may be due to trauma or chronic mechanical overload of the joint with abnormal weight bearing. The limited motion in the great toe joint is due to bone spurring and arthritis of the big toe joint which causes jamming and pain.

Presenting Patient Symptoms:

  • Limited motion of the great toe joint.
  • Stiffness of the great toe joint
  • Pain in the great toe joint.
  • Swelling of the great toe joint.
  • Cracking or grinding in the great toe joint.

What is commonly noted is that the patient will present initially with mild complaints and can often be treated with shoe modifications and orthotics or custom insoles. Patients will often state that this improves their pain because they are not placing as much weight through the great toe region.  However, over time, a certain number of patients will get increasing pain as the arthritis gets worse resulting in arthritis.

The diagnosis is made with examination and x-rays of the foot to see the level of arthritis and joint damage to the great toe.  It is rare but in some cases of local cartilage damage of possible cartilage lesions of the great toe, an MRI may be performed.

In most cases, surgical treatment of bone spurs and great toe arthritis is necessary.  As the arthritis gets worse, the surgery is more difficult and requires more invasive options.

Advancements in surgical options for hallux limitus/rigidus are growing and getting better and better.  We feel at this point that we have excellent options to offer patients and have come up with multiple treatment options to fit our patient’s needs. Addittionally, our California podiatrists and surgeons are internationally renowned.

Advanced Hallux Limitus/Rigidus Surgical Treatment are:

  • Cheilectomy of bone spur removal
  • Osteotomy for realignment and joint decompression
  • Midfoot fusion for 1st metatarsal repositioning
  • Hemi base implant joint resurfacing
  • Great toe fusion

Each choice has given positive and negative aspects.  In general, early cases of spurring with limited joint damage do well with cheilectomy.  As the problem proceeds, we tend to have less cartilage to work with which then requires implant or great toe fusion options to be used.  If the 1st metatarsal bone is very loose and seems to be drifting upwards resulting in jamming of the great toe joint, then a fusion of the metatarsal at the base is a good option to realign the first metatarsal and prevent the jamming at the great toe joint.

University Foot and Ankle Institute has extensive experience in the treatment of hallux limitus/rigidus and great toe arthritis.  We are well versed in all treatment options for big toe arthritis including spur removal, osteotomy, fusion and implant options.  For more information or to schedule an appointment with one of our doctors, please call 877-677-0011 or visit our website page of hallux limitus/rigidus at www.footankleinstitute.com/hallux-limitus.

Dr. Bob Baravarian

Dr. Bob Baravarian

Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as co-director of University Foot and Ankle Institute. He is Editor Emeritus of the international medical journal, Foot and Ankle Specialist.

Dr. Baravarian been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He servers as a consultant to the ATP (Association of Tennis Professionals) tour, multiple running organizations and several shoe manufacturers. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

Podiatrist Dr. Bob Baravarian is available for consultation at the Santa Monica, Sherman Oaks and UCLA Westwood offices.
Dr. Bob Baravarian

Leave a Reply

Your email address will not be published.

16 − three =

  • Yelp
    I am 4 weeks post surgery now and just got my cast off today. Dr. Franson is the BEST foot specialist I have ever been to. He is extremely kind, he's caring and compassionate. He truly cares about his patients and has...
    Kathleen C.
  • CustomerSure
    Great service!
    Stella P.
  • Yelp
    Dr. Franson is the best. I wish he was an internal medicine doctor, then he could be my primary care doc. I can't believe I picked him out of the yellow pages when I was new to the area 10 years ago. Dr. Franson was...
    Moira S.
  • CustomerSure
    Really appreciate the treatment of my ankle from Dr. Morris.
    Myhoa H.
  • CustomerSure
    I'll love you even more if I get my boot off tomorrow!
    Linda H.
  • Angies List
    I was treated very well. I have a recheck on Wednesday. Dr. Bob is very personable. He is the head of podiatry at UCLA Medical Center. He's been doing this kind of surgery for 17 years. He is very knowledgeable. He wa...
    Anonymous
  • Dr. Franson and Dr. Yau are GREAT. I've referred my daughter and will continue to refer patients. I called Dr. Franson on Labor Day evening and he answered, took the time to talk to me and gave me direction as to seei...
    Joan A.
  • Google+
    I had been dealing with heel pain for far too long and went to seek treatment from University Foot and Ankle. Within three weeks my pain decreased for the first time in four years. No drugs, no surgery and no BS from ...
    Greg A.
  • CustomerSure
    I have already recommended Dr Baravarian to my friend Lynn. Thank you so much. Great staff is everything, and you were awesome and sweet!
    Debbie T.
  • CustomerSure
    Very satisfied, and will definitely recommend to friends and family!
    Pauline M.
Same day appointments now available!
or call 24/7:
  • University Foot & Ankle, a Preferred Provider to:
  • UCLA Health System - UCLA Medical Group
  • MPTF - Member Industry Health Network
  • Cirque du Soleil
  • ATP - Association of Tennis Professionals
  • And consulting physicians for:
  • C&S - Cedars-Sinai
  • Saint John's Health Center