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Hallux rigidus, or arthritis of the big toe, can cause significant pain and limit mobility. Keller excision arthroplasty is a surgical procedure designed to alleviate discomfort, improve toe alignment, and restore range of motion. Here’s a detailed guide to help you understand the procedure and recovery process. What is Keller Excision Arthroplasty? Keller excision arthroplasty involves the removal of part of the big toe joint to reduce pain and improve functionality. During the procedure, the base of the big toe joint is excised, and any excess bone is removed. This surgery does not require internal fixation (such as screws) or bone healing, making recovery more straightforward in many cases. The procedure typically lasts about 30 minutes and is performed under local anaesthesia. In some cases, a temporary wire may be used to stabilise the joint; this wire will be removed during a follow-up appointment. Why Consider This Surgery? The main goals of Keller excision arthroplasty are: To reduce pain caused by arthritis or deformity. To improve big toe alignment. To restore range of motion and improve overall foot function. Advantages: No internal fixation or bone healing is required. Relatively short procedure and recovery time. Risks and Considerations While the surgery is generally effective, there are specific risks to consider: Continued joint pain. Pain in the ball of the foot (metatarsalgia). Shortening of the big toe, which may result in the toe not touching the ground. Weakness or malalignment of the big toe. Recurrence of deformity or the toe drifting into hallux varus (a deformity where the big toe points inward). Your consultant will discuss these risks with you and explain how they are managed to ensure the best outcome. Who is a Candidate for This Procedure? This surgery is typically recommended for individuals with: Painful hallux rigidus that has not responded to non-surgical treatments. Hallux valgus (bunions) with severe arthritis in the joint. Reduced activity levels due to mobility limitations. Alternative treatments include: Activity modification. Painkillers and anti-inflammatory medications. Custom footwear and orthotic foot supports. Joint injections or other surgical options, such as joint fusion or decompression osteotomy. What to Expect During Surgery The procedure is performed under local anaesthesia, ensuring you remain awake but pain-free. If preferred, local anaesthesia with sedation or general anaesthesia can also be considered. Following the surgery, you will spend time in the day surgery unit for post-operative monitoring before going home. A responsible adult must accompany you home and assist you during the first night after surgery. Recovery Timeline Initially (First 2 Weeks): Pain is most pronounced during this phase, but prescribed painkillers will help manage discomfort. Rest is essential. Keep your foot elevated and minimise movement. Use crutches if needed, and limit walking to essential activities such as bathroom trips. Two Weeks After Surgery: Attend a follow-up appointment to check your progress. Sutures may be removed, and additional dressings applied if necessary. If a temporary wire is used, it will be removed at this stage. Many patients can transition to wearing regular shoes, though some may require additional time. 2-8 Weeks After Surgery: Swelling and mild discomfort are common but will gradually decrease. You may begin light activities and weight-bearing as tolerated, wearing supportive shoes. Physiotherapy or rehabilitation exercises may be recommended to improve strength and mobility. 8-12 Weeks After Surgery: The foot should feel more functional and natural. Swelling continues to subside, and you may consider returning to sports and other activities based on your recovery progress. Beyond 12 Weeks: You will have a final review 6-8 months post-surgery to evaluate long-term progress. Improvements in pain, alignment, and mobility will continue to be noticeable over time. Planning for Recovery To ensure a smooth recovery: Arrange for assistance with daily tasks during the initial weeks. Follow all post-operative care instructions provided by your consultant. Attend all follow-up appointments to monitor healing and address any concerns. Keller excision arthroplasty is an effective option for individuals with hallux rigidus seeking pain relief and improved mobility. With proper preparation and adherence to recovery guidelines, most patients experience significant improvements in their quality of life. Consult your healthcare provider to determine if this procedure is the right choice for your needs.

Hallux rigidus, or arthritis of the big toe joint, can cause significant pain and restrict mobility. The cheilectomy procedure offers an effective solution to alleviate discomfort, improve joint function, and restore mobility. Here’s what you need to know about this procedure and its recovery process. What is the Cheilectomy Procedure? The cheilectomy procedure is designed to address hallux rigidus by removing bony outgrowths and joint debris. This process improves joint motion, reduces pain, and helps straighten the toe. As a joint-preserving surgery, it often leads to an enhanced range of motion without requiring permanent fixation or implants. The procedure typically takes about 30 minutes and does not require the use of a cast. Absorbable stitches are commonly used to minimise the need for removal. Why Consider This Surgery? The primary aims of a cheilectomy are: To reduce pain caused by arthritis or prominent joints. To improve the alignment and mobility of the big toe. To decrease the formation of calluses or corns caused by the deformity. Advantages: A joint-preserving procedure that maintains and may improve movement in the affected toe. Risks and Considerations While the procedure is generally successful, some risks include: Residual stiffness or joint pain. Increased pressure or discomfort in the ball of the foot. Recurrence of symptoms. Your consultant will discuss these risks with you and explain how they will be managed to ensure the best outcome. Who is a Candidate for This Procedure? This surgery is typically recommended for individuals experiencing: Arthritis in the big toe joint. Pain caused by prominent joints. Difficulty wearing sensible footwear due to the deformity. Alternative Treatments: Altering activity levels. Using painkillers or anti-inflammatory medications. Changing footwear styles. Joint injection therapy. Other surgical options, including 1st MTP joint fusion or excisional arthroplasty. What to Expect During Surgery The procedure is performed under local anaesthesia, which may include a series of injections around the ankle or behind the knee. This ensures that you remain awake but pain-free. Sedation or general anaesthesia can also be used if preferred. Although the procedure takes about 30 minutes, you should plan to spend a few hours in the day surgery unit to rest before heading home. It is essential to have a responsible adult accompany you and assist you during the first 24 hours post-surgery. Recovery Timeline First 2-4 Days: Pain is typically most intense during this period, but prescribed painkillers will help manage discomfort. Rest is essential. Keep your foot elevated and minimise walking. Use crutches as instructed to limit weight-bearing on the operated foot. One Week After Surgery: Attend a follow-up appointment for dressing changes and progress checks. Gradually increase activity within pain limits. Pain or swelling indicates overexertion. Two Weeks After Surgery: Sutures will be removed if necessary. Bandages and crutches are no longer required, and you can get your foot wet. Begin wearing trainer-style shoes and performing gentle toe exercises to maintain mobility. 2-6 Weeks After Surgery: The foot begins to feel more normal, though some swelling may persist. By six weeks, 89% of patients can return to wearing regular shoes. You may return to non-manual work; manual labour may require additional recovery time. Driving can resume if you can safely perform an emergency stop. Confirm this with your insurance provider. 8-12 Weeks After Surgery: Swelling reduces further, and the foot feels more functional. Sporting activities may be reintroduced after three months, depending on your recovery progress. Six Months After Surgery: Attend a final review to assess long-term recovery. Swelling should be minimal, and most patients experience the full benefits of the surgery. Twelve Months After Surgery: Full healing is achieved, and improvements in alignment and comfort will stabilise. Planning for Recovery To ensure a smooth recovery: Arrange for assistance with daily tasks during the initial weeks. Follow all post-operative care instructions provided by your consultant. Attend all scheduled follow-up appointments to monitor healing progress. The cheilectomy procedure is an effective option for relieving pain and improving mobility in patients with hallux rigidus. With proper care and adherence to recovery protocols, most patients experience significant improvements in their quality of life. If you are considering this procedure, consult your healthcare provider to determine if it is the right choice for you.

If you’re experiencing persistent foot pain caused by a flat or high-arched foot, calcaneal osteotomy might be a solution worth considering. This surgical procedure can significantly improve foot alignment, reduce pain, and address the underlying causes of deformity. Let’s explore the details of this surgery and its recovery process. What is Calcaneal Osteotomy? Calcaneal osteotomy is a procedure that involves reshaping and repositioning the calcaneus, or heel bone, to improve the alignment and function of the foot. It is often performed to correct painful flat feet or high-arched feet and can be combined with other procedures, such as Achilles tendon lengthening, for comprehensive correction. During the surgery, the surgeon makes an incision on the outer border of the foot near the heel and performs a precise bone cut. The heel bone is then repositioned, and fixation devices such as screws or plates with screws are used to secure the bone in its new position. These devices are typically not noticeable and do not usually require removal. The operation typically takes 30 to 60 minutes and is performed under local anaesthesia, often with sedation or general anaesthesia as an option. Why Consider This Surgery? Calcaneal osteotomy offers several benefits for those suffering from foot deformities: Improves the arch profile and overall alignment of the foot. Reduces pain caused by poor foot mechanics. Addresses the root cause of the deformity, leading to long-term relief. Risks and Considerations As with any surgical procedure, calcaneal osteotomy has potential risks, including: Recurrence or collapse of the foot. Nerve damage, which may cause loss of sensation on the outer part of the foot. Failure of bone healing (non-union). Your surgical team will discuss these risks with you and take every precaution to minimize complications. Who is a Candidate for This Procedure? This surgery is typically recommended for individuals with: Painful flat feet or high-arched feet that have not responded to conservative treatments. Persistent pain or difficulty in wearing footwear despite using orthotics or other supportive devices. Before considering surgery, your healthcare provider may suggest alternatives, such as: Activity modifications. Pain management with anti-inflammatory medications. Stretching exercises or night splints. Custom footwear or orthotic foot supports. What to Expect During Surgery The procedure can be performed under a local anaesthetic block, ensuring that you remain awake but pain-free. If preferred or deemed necessary by your surgeon, sedation or general anaesthesia may be used. Calcaneal osteotomy is typically a day surgery, allowing you to go home the same day. However, you will need a responsible adult to assist you on the first night post-surgery to ensure your safety and comfort. Recovery Timeline Immediately After Surgery: Pain management will be prioritized, and you’ll be provided with appropriate medications. Your foot will be non-weight bearing, supported in a cast or air cast boot, for the first 6-8 weeks. Rest is essential, and your mobility should be limited to essential activities like using the bathroom, with the aid of crutches. Within Two Weeks Post-Surgery: You’ll attend a follow-up appointment for dressing changes. Sutures may be removed if necessary. A new cast or air cast boot may be applied, depending on your progress. X-rays may be taken to monitor healing. 2-8 Weeks Post-Surgery: Depending on your progress, you may begin weight-bearing activities as advised by your surgeon. Transition to supportive footwear, like lace-up trainers, to aid mobility. Swelling and mild discomfort are normal as activity levels increase. Rehabilitation exercises or physiotherapy may be introduced to restore strength and flexibility. 8-12 Weeks Post-Surgery: Swelling continues to decrease, and your foot begins to feel more normal. Gradual return to daily activities, including some sports, may be possible. Beyond 12 Weeks: A final follow-up is typically scheduled at 6-8 months post-surgery to assess long-term outcomes. Improvements in foot alignment and pain relief become more noticeable over time. Planning for Recovery Proper preparation is key to a smooth recovery. Ensure you have: A support system to help with daily tasks during the non-weight-bearing phase. Crutches or mobility aids for initial movement. Arrangements for childcare or caregiving responsibilities if needed. Calcaneal osteotomy is a proven solution for individuals with painful flat feet or high arches, offering improved alignment and long-term pain relief. By understanding the procedure and following recovery protocols, you can look forward to better mobility and quality of life. If you’re considering this surgery, speak with your healthcare provider to determine if it’s the right option for you.