Surgery for hallux rigidus depends on the severity of the arthritis. Cheilectomy (removing bone spurs) is suitable for mild-to-moderate disease, while joint fusion is the most reliable operation for severe disease. This guide covers both.
ℹ️ This appointment takes place 2-4 weeks before surgery. Most patients are otherwise well, so the assessment is usually straightforward.
You will have routine pre-operative checks and meet the anaesthetic team. The team will confirm which procedure is planned and answer any questions.
Standard pre-operative checks.
Blood thinners may need to be paused before surgery.
Usually performed under regional ankle block with sedation, or general anaesthesia. The block gives 12-18 hours of post-operative pain relief.
You will need a heel-weight-bearing surgical shoe for around 6 weeks after fusion, or a few weeks after cheilectomy.
Arrange help for the first few days. Keep the foot elevated as much as possible to reduce swelling.
ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
Most foot and ankle surgery is performed as a day case, meaning you go home the same day. More complex procedures such as ankle replacement or flat foot reconstruction usually require 1-3 nights in hospital. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
A nurse will check the wound before you leave and explain how to keep it clean and dry.
You will be shown how to use crutches and given clear instructions about weight-bearing on your operated foot.
You will receive a letter for your GP and details of your next outpatient appointment, usually at 2 weeks for a wound check.
Arrange for a family member or friend to collect you. You must not drive after a general anaesthetic or sedation.
⚠️ Important: After fusion, the big toe is permanently stiff. Most patients adapt very well, but consider this carefully if your footwear or activities require big toe motion (such as ballet or high-heeled shoes).
Keep the foot elevated above the level of your heart for as much of the day as possible during the first 2 weeks. This significantly reduces swelling and helps healing.
Avoid getting the wound wet until it is fully healed, usually 10-14 days. Use a waterproof cover when showering.
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective than taking it only when needed.
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, calf pain or swelling (possible DVT), shortness of breath, or a temperature above 38°C.
Foot wrapped, kept elevated. Heel-weight-bearing in surgical shoe for fusion; gentle motion encouraged after cheilectomy.
Outpatient appointment to check the wound. Stitches removed.
Cheilectomy: transition to comfortable shoes. Fusion: continued surgical shoe.
X-rays confirm successful joint fusion. Transition to normal shoes.
Return to all desired activities. Most fashion footwear is achievable after cheilectomy, but high heels are not possible after fusion.
Yes. Most patients walk normally and even run. The toe is fixed in a slightly bent-up position which mimics normal gait.
Yes. This is a common strategy. Around 20% of cheilectomy patients eventually progress to needing fusion.
Desk work: 1-2 weeks (cheilectomy) or 2-4 weeks (fusion). Standing work: 4-8 weeks. Manual work: 8-12 weeks.
For right-sided surgery, around 4-6 weeks. Left foot in an automatic car, around 1-2 weeks if comfortable.
Plain-English answers to the things people most often ask, grounded in published guidance. Tap a question to open it.
A cheilectomy removes the bony spur and keeps movement in the big toe joint; it suits milder arthritis. A fusion reliably relieves pain in advanced arthritis but leaves the joint stiff.
The choice depends on how worn the joint is.
A cheilectomy trims the spur and tidies the joint. A fusion joins the joint with a plate or screws so it heals solidly in a good position.
Both are usually day-case operations.
Often a general or spinal anaesthetic with a foot block for pain relief.
Your anaesthetist will go through the options.
Expect a special shoe or boot for some weeks. A fusion needs the bone to unite before normal walking.
Swelling settles over months.
Most people walk well and comfortably after a fusion. Running and high heels are limited because the toe no longer bends.
Day-to-day activity is usually very acceptable.
Spreading redness, discharge or a temperature can signal infection, and calf or chest symptoms can signal a clot.
Seek prompt help if these occur.