Stiff, aching big toe joints can quickly put a damper on your favorite activities. You used to love taking evening walks around Lady Bird Lake or meeting friends to explore the latest East Austin galleries. But now, arthritis pain in your big toe makes every step excruciating. Shoes that once felt comfortable now rub and aggravate your bunion, making you wonder if you'll ever find relief.
For many Austin residents, bunions and big toe arthritis go hand-in-hand. As the big toe moves out of alignment, the joint endures excess pressure and friction. Over time, this can accelerate the development of osteoarthritis. At Austin Foot and Ankle Specialists, we've helped thousands of patients address both bunions and arthritis to keep their feet as healthy and functional as possible.
One treatment option that has generated a lot of buzz is Lapiplasty bunion surgery. This innovative procedure not only corrects the cosmetic appearance of a bunion but also addresses the root cause of the deformity. It's a potential option for patients with mild to moderate arthritis who hope to preserve big toe joint motion. Let's take a closer look at how it works.
Understanding the Link Between Bunions and Big Toe Arthritis
Many people think of bunions as a bump on the side of the big toe. However, a bunion is actually a complex deformity that involves changes to the bone alignment and soft tissues of the forefoot.
In a normal foot, the first metatarsal bone sits in a relatively straight line with the other metatarsals. The big toe points forward in line with the first metatarsal.
In a foot with a bunion, the first metatarsal shifts out of alignment and angles toward the second toe. At the same time, the big toe drifts toward the smaller toes. The metatarsal head juts out on the inner edge of the foot, creating the characteristic bump.
This misalignment puts excess strain on the metatarsophalangeal (MTP) joint, where the big toe connects to the first metatarsal. The MTP joint bears a lot of force during walking and running. In fact, research shows this joint carries about 119% of your body weight with each step.
When a bunion changes the angle of the bones, it alters how force moves through the joint. Excess pressure breaks down the cartilage, leading to inflammation, stiffness, and pain. The joint may develop bone spurs. In advanced cases, the cartilage wears away completely, leaving the bones to rub against each other.
Several factors can contribute to the development of bunions, including:
- Genetics: Certain inherited foot structures make you more prone to bunions. If your parents or grandparents had bunions, you have a higher risk of developing them too.
- Shoe Choices: High heels and narrow, pointed shoes put excess pressure on the forefoot. Over time, this can contribute to bunion formation.
- Occupation: Jobs that involve long periods of standing or walking, especially on hard surfaces, increase your bunion risk.
- Conditions Affecting Joint Stability: Health issues like rheumatoid arthritis, cerebral palsy, and multiple sclerosis can increase joint instability and lead to bunions.
Lapiplasty: Addressing the Root Cause of Bunion Deformities
Traditional bunion surgery focuses on shaving off the bony bump and realigning the soft tissues around the MTP joint. These procedures can help relieve pain and improve the cosmetic appearance of the foot. However, they don't address the rotation of the first metatarsal that caused the bunion to develop.
Lapiplasty uses special titanium plates to secure the unstable joint between the first metatarsal and the midfoot bone. This joint, called the tarsometatarsal (TMT) joint, normally has minimal motion. In patients with bunions, the TMT joint becomes hypermobile, allowing the metatarsal to shift out of position.
By stabilizing the TMT joint, Lapiplasty stops the progression of the bunion deformity at its source. The surgeon can then realign the first metatarsal and big toe to restore normal anatomy.
Key advantages of Lapiplasty include:
- Addressing All Planes of the Deformity: Traditional osteotomies focus solely on the transverse (sideways) angle of the metatarsal. Lapiplasty addresses the transverse, sagittal (up and down), and frontal (rotational) planes for more comprehensive correction.
- Faster Return to Activity: Secure joint fixation allows patients to begin weight-bearing sooner. Most patients walk in a surgical boot within days of surgery.
- Lower Risk of Recurrence: By stabilizing the unstable joint, Lapiplasty reduces the risk of bunion recurrence. Studies show a 97% success rate at 13-month follow-up.
Lapiplasty for Patients With Big Toe Joint Arthritis
So, can Lapiplasty help if you already have arthritis in your big toe joint? The answer depends on the severity of your cartilage damage and deformity.
In general, patients with mild to moderate arthritis may be good candidates for Lapiplasty. The procedure can help relieve pain and preserve remaining cartilage by restoring normal joint alignment. Removing bone spurs and repairing damaged soft tissues can also improve MTP joint function.
However, Lapiplasty may not be appropriate if arthritis has caused severe joint damage. If the cartilage has worn away completely, a joint fusion or implant may be necessary to relieve pain.
During your initial consultation, your podiatrist at Austin Foot and Ankle Specialists will carefully evaluate your specific condition. X-rays and other imaging scans provide valuable information about the extent of your bunion deformity and level of arthritis. Your doctor will also ask about your symptoms, lifestyle goals, and treatment preferences.
Recovering From Lapiplasty With Big Toe Arthritis
Recovery timelines can vary depending on your age, health, and the specifics of your surgery. In general, patients wear a walking boot for about six weeks after Lapiplasty. Your doctor will let you know when it's safe to transition back to comfortable walking shoes.
Physical therapy is a key part of the recovery process. Specific exercises help restore strength and range of motion in the big toe joint. Your physical therapist will also teach you strategies to protect the joint and manage any ongoing arthritis symptoms.
Most patients experience significant improvement in their bunion pain after surgery. However, it's important to understand that arthritis is a progressive condition. While realigning the MTP joint can relieve pain and help preserve remaining cartilage, it can't reverse joint damage that has already occurred. Your doctor may recommend ongoing treatments to manage your arthritis symptoms and slow the progression of the disease.
At Austin Foot and Ankle Specialists, our goal is to help you maintain your mobility and quality of life. From conservative therapies to advanced surgical procedures like Lapiplasty, we're here to help you put your best foot forward.
