Foot Arthritis Treatments
What is Arthritis?
Arthritis is a general term for numerous conditions that damage the function of normal working joints in the body. The foot has 33 joints which are all susceptible to arthritis and can result in degeneration of cartilage, pain, swelling and stiffness.
What happens if Arthritis of the foot is left untreated?
Unfortunately, Arthritis is generally progressive in nature and generally gets worse with time. Cartilage does not have the ability to regenerate damage is not reversible. Appropriate treatment of arthritis addresses both pain and joint deformity and if left untreated, may eventually lead to deformity. Early recognition, diagnosis, and treatment is essential to prevent the progression and allows patients to remain active and pain free.
What is the non-operative treatments for Arthritis of the foot?
Patients with early evidence of posterior tibial tendon insufficiency leading to adult acquired flatfoot deformity and minimal pain are encouraged to attempt non-surgical treatments. This usually involves activity modification, orthotic arch supports, physical therapy encourage stretching and muscle rebalancing and anti-inflammatory medications.
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What are the surgical treatments for Arthritis in the foot?
Surgery is offered to patients with persistent pain and symptoms despite all attempts at non-operative treatments. The goal of surgery is to relieve your pain and allow you to function normally in your daily actives.
Every arthritic foot is different, and a detailed pre-operative assessment by Dr. Chow will ensure the appropriate operation can be tailored to the individual patient. Dr. Chow has extensive experience locally and internally on the various procedures that are required to address these factors and will offer you the best procedure to fit the needs of your foot.
Flatfoot Surgery may involve:
- Realignment of multiple bones of the foot and ankle
- Fusions (Joining of affected bones) of the foot and ankle
- Excising bony prominences
- Bone Grafting
- Implantation of artificial grafts or prosthesis
- Tendon Transfers and Reconstructions
- Soft tissue balancing
What to expect after foot Arthritis surgery?
Hallux Rigidus (Great toe stiffness)
You should expect to stay one night in hospital to allow for adequate pain control and a thorough physiotherapy assessment. You will be placed in a post-operative shoe to take the pressure off the joint and allowed to weight bear immediately.
Dressings are to remain dry and intact until your first post-operative appointment. Your sutures will be removed after 2 weeks and scar massage, desensitization commenced at that time.
You will remain in the shoe for 6 weeks and then transitioned into a normal shoe along with physiotherapy for strengthening, range of motion and balance retraining.
Patients can return to normal activities at 3-4 months post operatively and expect up to 6 months for a full recovery.
Midfoot Arthritis
You should expect to stay 3-4 nights in hospital with your leg elevated. This will allow for adequate pain control and a thorough physiotherapy assessment. You will be placed in a post-operative boot and advised not to weight bear on the foot. Blood thinners will be commenced to prevent clots and continued for the duration in the boot.
Dressings are to remain dry and intact until your first post-operative appointment. Your sutures will be removed after 2 weeks and scar massage, desensitization and early ROM will commence with a physiotherapist. A repeat x-ray will be undertaken at 6 weeks and a CT scan at 10 weeks with the expectation to be in the boot for at least 12 weeks total.
At 3 months the boot will be removed and transition into normal shoes along with physiotherapy for strengthening, range of motion and balance retraining. The ongoing recovery usually lasts for up to 6-9 months.
Potential complications of Arthritis Surgery in the foot
All surgical procedures involve inherent risk of complications. However, these risks are generally uncommon and quite infrequent. These include anesthetic complications, wound infections, nerve injuries, tendon injuries, bleeding, fracture, failure of bone to heal, mal positioning of bone, ongoing pain, chronic regional pain syndrome, blood clots, recurrence of the deformity and development of arthritis in other joints.
Patients can minimise the risk of complications by carefully following post-operative instructions.
