Hallux Rigidus – Arthroplasty

Post-operative Guide

Surgery for big toe arthritis: big toe joint replacement or hemiarthroplasty (hemiCAP)

Dressings

Dressings

Compressive bulky dressing is applied over a waterproof dressing. The bulky dressing may be removed after 72 hrs. The water proof dressing is applied in the OR, and is to remain intact and kept clean and dry at all times for the first 1 week until first review in the office.

Elevate

Elevate

As much as possible

Ice

Ice

At least 3 times per day 20 mins on, 20 mins off. Ice should not be directly contacting skin, or dampen the plaster.

Weight Bearing Status

Heel weight bearing as tolerated in the postoperative shoe provided.

Pain Medication

Strong pain medication < 72 hrs if needed. A script will be provided at the time of surgery. No Alcohol or driving whilst taking strong pain medication

Decrease to simple pain medication e.g. panadol/nurofen after 72 hours.

DVT (Deep Venous Thrombosis or blood clots) prophylaxis:
100mg aspirin daily for 2 weeks post surgery OR other anticoagulation as prescribed

Exercises

Driving

  • Casts and boots and strong pain medications can interfere with your ability to drive
  • You must be able to safely operate the vehicle including the accelerator, brake and clutch pedals at all times and respond appropriately in the event of an emergency
Swelling

  • Expected to decrease when elevated and gradually decrease over time
  • May have persistent swelling for up to 2 years post surgery
Physiotherapy

  • 1 week
    • commence gentle ROM exercises of 1st MTPJ
  • 4 weeks
    • transition to normal running shoe with stiffer, supportive sole
    • gait retraining
  • 6 weeks
    • gait retraining and ROM exercises to continue until range maximised
    • core strengthening and upper limb program
    • generalised stretching/strengthening fitness program
    • progressive increase in lower limb weight bearing exercises
    • stationary bike, swimming
Travel

Please discuss any travel plans prior to your surgery.

It is usually safe to travel short distances on a plane or car 1 week after surgery. You may experience increased swelling therefore try and keep the limb elevated

It is more difficult to get around the airport and plane. You will need assistance. If there is any concern regarding DVT then air travel or long car travel is not advised. In general long haul flights should be avoided for at least 3 months post surgery.

Please take usual precautions for healthy travel such as elevation of the limb, regular movements of the limb and moving around the cabin, stay well hydrated and avoiding alcohol. Additional DVT prophylaxis may be required.

Return to Sports

  • Expected after transition to a normal shoe has occurred and fitness has improved
  • Allow at least 3-4 months for higher impact activities e.g. running
Time Off Work

  • 2-3 weeks if office work
  • 3-4 weeks if standing
  • 12 weeks + if heavier manual work
Follow Up

  • 1 week
    • wound review and removal of any sutures
  • 6 weeks
    • repeat X-rays and progress to shoe wear
  • 12 weeks
    • repeat X-rays
  • 6 months
    • repeat X-rays
  • 12 months
    • repeat X-rays
  • 24 months
    • repeat X-rays

For all appointments and enquiries, please phone 07 5645 6913 or email info@salusfootsurgeon.com.au

9 Kinloch Avenue
Benowa QLD 4217

   

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