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Cheilectomy Surgery for Hallux Rigidus

Patients with hallux rigidus may benefit from a surgical procedure called cheilectomy. This article explains the procedure as well as answers questions about hallux rigidus.

If you are looking to explore your treatment options, then book an appointment with Orthopedic Foot & Ankle Center in Greater Columbus. Our foot and ankle surgery specialists can help you find a solution. Contact us today.

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Topic at a Glance

  • Cheilectomy is a surgical procedure for hallux rigidus that removes bone spurs/excess bone from the big toe joint to improve joint movement and address pain and stiffness.
  • Cheilectomy may be appropriate when hallux rigidus is mild to moderate or in its early stages, particularly when non-surgical treatment has not provided enough relief.
  • Most patients can walk immediately in a protective shoe, although walking and weight-bearing may initially be restricted.
  • Possible risks include infection, nerve injury, persistent pain or swelling, and the possibility of further treatment if arthritis progresses.

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What is a Cheilectomy?

A cheilectomy is a surgical procedure used to treat hallux rigidus. During the procedure, the surgeon removes bone spurs from the big toe joint.

These bony growths can limit the toe’s ability to move upwards and can cause pain and stiffness. The goal of the surgical procedure is to remove the excess bone and improve joint movement. This type of surgery is often recommended when hallux rigidus is in its early stages or is mild to moderate.

What is Hallux Rigidus (Big Toe Arthritis)?

Hallux rigidus is arthritis that affects the metatarsophalangeal joint (MTP joint) at the base of the big toe. Arthritis can wear down the joint surfaces and lead to pain, stiffness, and reduced mobility. The movement in this joint is important for walking.

A doctor examining a patient’s big toe to treat pain and limited movement in Ohio.

What Causes Hallux Rigidus?

Hallux rigidus often develops over time with no clear cause. As you age, the cartilage that cushions the joints slowly wears down. This leads to osteoarthritis, a common cause of hallux rigidus.

Risk factors can include overusing the MTP joint in activities such as running or through your occupation, or an injury such as stubbing your toe.

Symptoms of Hallux Rigidus

The main symptom of hallux rigidus is pain and stiffness in and around the big toe joint. You may also experience difficulties moving your big toe upwards. This restricted movement can affect activities such as walking and playing sport. Some people have visible swelling around their toe joint.

Non-Surgical Treatment Options for Hallux Rigidus

Treatment for hallux rigidus generally begins with non-surgical options. The goal of conservative treatment is to relieve pain, reduce stiffness, and maintain joint movement. Non-surgical treatments for hallux rigidus may include the following:

  • Activity modification
  • Wearing shoes with a larger toe box
  • Toe pads to support and restrict toe movement
  • Pain relief medications such as NSAIDs
  • Corticosteroid injections

How is Cheilectomy Surgery Performed?

If non-surgical treatment has not helped, then you may benefit from cheilectomy. The purpose of this surgical procedure is to remove bone spurs from around the big toe joint. This creates more space in the bone joint to allow for greater movement.

This procedure can be done through open surgery or through small incisions in a minimally invasive procedure. Minimally invasive cheilectomy uses incisions less than 1cm. Tiny instruments will then be used to remove the excess bone through this keyhole incision. The procedure can be done using a local anesthetic or general anesthetic.

Possible risks include infection, nerve injury, or persistent pain or swelling. In some cases, patients need further treatment if the arthritis continues to progress.

What to Expect During Recovery

Cheilectomy surgery is an outpatient procedure, meaning you can return home the same day. Most patients can walk on their foot immediately after surgery in a protective shoe. However, there will be restrictions on weight-bearing, such as limiting how much you can walk and walking on your heel.

You can help reduce swelling by keeping your foot elevated as much as possible for the first few days. NSAIDs can also help with swelling and pain. Swelling will last from a few weeks to a few months. During recovery, you will wear a protective boot for about 2-3 weeks. The shoe has a hard sole that supports your foot. After 3 to 6 weeks, you can return to wearing your regular shoes.

Post-operative rehabilitation will usually include gentle range of motion exercises to prevent stiffness in your toe. Most people can return to work within one or two months. However, if your job requires movement, it may take longer.

Schedule a Consultation for Hallux Rigidus

If you are experiencing big toe stiffness, pain, or limited movement, then get an evaluation at Orthopedic Foot & Ankle Center in Greater Columbus. Our foot and ankle specialists can evaluate your condition and provide the appropriate treatment. Book your appointment today.

Medically reviewed by Roberto A. Brandão, DPM, FACFAS

FAQs About Cheilectomy Surgery for Hallux Rigidus

Cheilectomy is used to treat hallux rigidus, or arthritis affecting the big toe joint. The procedure removes bone spurs/excess bone to create more space and improve movement.

Cheilectomy may be considered when hallux rigidus is in its early stages or is mild to moderate, particularly when non-surgical treatments have not provided sufficient relief.

Most patients can walk on the foot immediately after surgery while wearing a protective shoe, but there may be restrictions on how much you walk and how much weight you place on the foot during early recovery.

You will wear a protective boot for approximately 2–3 weeks, then return to regular shoes after around 3–6 weeks. Many people can return to work in roughly 1–2 months. Recovery may take longer for those with jobs requiring more movement.

Possible risks include infection, nerve injury, persistent pain or swelling, and the possibility of needing further treatment if the underlying arthritis continues to progress.

Our Total Ankle Replacement Specialist​s​

TERRENCE M. PHILBIN, DO

Board Certified Orthopedic Surgeon

MARK A. PRISSEL, DPM

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RANDALL C. THOMAS JR., DPM

Board Certified Foot & Ankle Surgeon

COREY J. GRIFFITH, DPM

Board Certified Foot & Ankle Surgeon
Dr. Robert Brandao

ROBERTO A. BRANDÃO, DPM

Board Certified, Fellowship Trained Foot & Ankle Surgeon
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