About Cheilectomy
A cheilectomy is a surgical procedure used to relieve pain and improve motion in the big toe joint (first metatarsophalangeal joint) caused by hallux rigidus, a form of arthritis that leads to stiffness, inflammation, and bony overgrowth.
In this procedure, the surgeon removes bone spurs (also known as osteophytes) that develop around the joint, which limit movement and cause painful friction when walking or bending the toe. By clearing these growths, cheilectomy helps restore joint mobility and reduce discomfort—often delaying or avoiding the need for joint replacement or fusion.
Preparing for Cheilectomy Surgery
Before surgery:
- A thorough clinical examination and imaging (X-ray) will assess the severity of arthritis and location of bone spurs.
- You’ll receive preoperative instructions, which may include fasting, adjusting medications, and arranging post-op care at home.
- The procedure is typically done outpatient, under local anesthesia with sedation or general anesthesia, depending on your needs and surgeon preference.
You should plan to take a few days off work and avoid driving until cleared.
Removing Bony Growths
During surgery:
- A small incision is made over the top of the big toe joint.
- The surgeon carefully removes bony prominences and any debris restricting movement.
- In some cases, the joint capsule may be loosened or a small portion of the dorsal joint surface shaved to allow smoother motion.
No joint fusion or implant is involved in a cheilectomy, which preserves joint function and allows natural movement post-recovery.
End of the Procedure
Once the bone spurs are removed:
- The surgeon tests the joint’s range of motion to ensure improved mobility.
- The incision is closed with sutures, and a sterile dressing is applied.
- You will be fitted with a postoperative shoe or boot to protect the foot while walking.
Most patients are able to bear weight immediately after surgery but may be advised to limit activity and elevate the foot in the first few days.
FAQs
Cheilectomy involves removing bone spurs and reshaping the joint at the base of the big toe. The procedure relieves pain and stiffness caused by hallux rigidus, restoring more comfortable motion in the toe.
You may be a candidate if you have moderate arthritis in the big toe joint, if bone spurs are limiting motion and causing pain, or if non-surgical treatments (orthotics, injections, PT) are no longer effective. Cheilectomy is often considered before more invasive options, such as joint fusion or replacement.
Most patients return to regular shoes within 2–4 weeks. Full recovery and return to sports or higher-impact activities may take 6–8 weeks. Mild swelling may persist for several months.
Cheilectomy has a high success rate—over 80% of patients report pain relief and improved function. It is most successful in patients with mild to moderate arthritis and good joint alignment.
The incision is typically 2–3 inches long and placed on the top of the foot, over the big toe joint. With proper healing, the scar is usually minimal and fades over time.
Though generally safe, potential risks include infection, stiffness or limited motion, nerve irritation or numbness, continued or recurrent pain, and in rare cases, progression of arthritis that may require further surgery.
