Suffering from big toe arthritis or hallux rigidus? Discover how minimally invasive cheilectomy surgery can relieve pain and restore joint motion.
Hallux rigidus, sometimes called hallux limitus, is a common condition that causes pain, stiffness, and inflammation in the big toe joint. As the arthritis progresses, patients may notice difficulty bending the toe, pain while walking, or a painful bump forming on top of the joint.
In this article, Dr. Lam explains how minimally invasive cheilectomy surgery can help restore motion and relieve pain for many patients suffering from early to moderate hallux rigidus.
What Is Hallux Rigidus?
Hallux rigidus is a form of arthritis affecting the big toe joint (first metatarsophalangeal joint). Over time, the joint cartilage wears down, leading to:
Pain in the big toe joint
Stiffness when bending the toe
Swelling or inflammation
A noticeable bone spur or bump on top of the joint
Difficulty walking or pushing off the foot
Many patients initially experience hallux limitus, meaning limited motion in the big toe. If the condition progresses, the joint may eventually become hallux rigidus, where motion is severely restricted or even completely locked.
Understanding the Arthritis Grading System
Doctors often classify hallux rigidus based on severity:
Grade 1:
Mild stiffness and small bone spurs. Joint cartilage is mostly preserved.
Grade 2:
Moderate arthritis with larger bone spurs and increased stiffness.
Grade 3:
Advanced arthritis with significant joint damage and reduced motion.
Grade 4:
Severe arthritis where the joint becomes completely rigid or locked.
Minimally invasive surgery works best for Grades 1 and 2, and in select cases Grade 3 patients may still benefit.
When arthritis reaches Grade 4, more extensive procedures such as joint fusion or implants are usually recommended.
What Is a Cheilectomy?
A cheilectomy is a surgical procedure that removes the bone spur and excess bone growth from the top of the big toe joint. By removing these structures, the surgeon can restore joint motion and reduce pain caused by impingement.
In Dr. Lam’s approach, the procedure is performed using minimally invasive surgery (MIS) techniques.
Benefits of MIS cheilectomy include:
Very small incision
Often only one stitch
Less tissue disruption
Faster recovery
Reduced post-operative pain
Real Patient Results
In the video demonstration, two patients returned for follow-up after their procedures.
Patient #1 – About One Month Post-Op
This patient had minimally invasive cheilectomy surgery and reported minimal discomfort during recovery.
The biggest challenge, according to the patient, was simply wearing the surgical shoe, not the surgical pain itself.
After surgery:
Range of motion improved
Pain was essentially gone
The patient returned to regular activity
Patient #2 – Less Than Two Weeks Post-Op
Another patient returned less than two weeks after surgery.
Results included:
Zero pain reported
Small incision with only one stitch
Excellent improvement in toe motion
High patient satisfaction
This patient also had a hammertoe correction, which was completed through another small incision.
What the X-Rays Show
Before surgery, X-rays revealed a large bone spur on the top of the big toe joint. This bump can block movement and cause painful catching during motion.
After the cheilectomy procedure, the X-ray shows a smooth joint surface, allowing the toe to move freely again.
Recovery After Minimally Invasive Cheilectomy
One reason patients appreciate MIS surgery is the relatively simple recovery.
Typical recovery includes:
Walking in a surgical shoe initially
Minimal stitches
Gradual return of toe motion
Follow-up visits to monitor healing
Many patients are surprised at how quickly they feel relief from their previous pain.
Why Early Treatment Matters
The best outcomes occur when hallux rigidus is treated early, before the arthritis becomes severe.
When addressed in Grade 1 or Grade 2, procedures like cheilectomy can:
Preserve the natural joint
Restore motion
Prevent progression of arthritis
Avoid more invasive procedures later
When Fusion or Implants Are Needed
If the joint becomes completely rigid (Grade 4), removing bone spurs alone may not provide relief. In those cases, surgeons may recommend:
Big toe joint fusion
Joint implant replacement
These procedures are typically reserved for the most advanced cases.
When to See a Foot Specialist
You should consider seeing a specialist if you experience:
Persistent big toe pain
Stiffness when bending the toe
Difficulty walking or exercising
A painful bump on top of the toe joint
Early evaluation allows doctors to determine whether conservative treatment or minimally invasive surgery is appropriate.
Final Thoughts
Hallux rigidus can significantly affect daily life, but modern minimally invasive surgical techniques offer effective solutions for many patients.
With small incisions, minimal stitches, and faster recovery, procedures like cheilectomy can restore motion and relieve pain—helping patients return to normal activities.
If you’re experiencing big toe pain or stiffness, an early evaluation may help prevent the condition from progressing.
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