Hallux rigidus or stiff toe can most easily be described as a deformity of the I. metatarsophalangeal joint of the foot (ie the toe joint), where the possibility of lifting the toe off the ground is limited, while the flexion movement of the big toe is usually completely preserved.
It is a typical degenerative process that causes changes that are typical of osteoarthritis of any joint in the body – cartilage damage, osteophytes (bone growths that mechanically block movement in the joint and cause pain), narrowing of the joint crack bodies) and subchondral sclerosis and cystic changes.
In terms of frequency of occurrence, hallux rigidus affects all age groups, although, similar to osteoarthritis itself globally, it is somewhat more common in the elderly. Regardless of the age at which this condition occurs, it is extremely uncomfortable due to seemingly simple but essentially extremely painful and life-limiting symptoms. At the same time, clearly, we mostly aim at great pain and limited movement “upwards” in the thumb joint.
Hallux rigidusthus occurs in two forms; primary or so-called. juvenile form, as a consequence of disorders in the ossification of the head of the metatarsal bone, and the secondary or adult form, where its occurrence is the result of several different factors.
The symptoms are dominated, as we have already stated, by pain in the thumb joint and limitation of the thumb bending “upwards”, but characteristic with the preserved possibility of bending the thumb “downwards”.
During the clinical examination, a lump can usually be clearly felt on the upper (dorsal) side of the thumb, which mechanically creates the stated limitations in the range of motion. For the final detection of hallux rigidus, an X-ray is used, which clearly shows the above-mentioned arthritic changes (narrowing of the joint crack, osteophytes, subchondral sclerosis, cystic changes). The image below shows the change clearly on the X-ray.
As for treatment, it can be conservative or operative, depending on the degree of hallux rigidus. In stage I of this condition, conservative treatment methods are used, which most often involve the production of specific insoles with a cylindrical sole. The pads reduce the awkward movement of the thumb “up”, and sometimes, although rarely, we use autologous conditioned plasma (PRP).
The most common method of treating this condition is surgery. Surgery is a method of treatment in all other degrees of damage. At II. degree of damage is used so-called. keilectomy(removal of osteophytes, ie bone growths on the upper side of the thumb that prevent movement in the thumb joint), while in III. degree of damage uses somewhat more invasive surgical treatment with partial arthroplasty of the joint. Previous practice in the most difficult cases (IV. degree of hallux rigidus) involved the application of so-called arthrodesis, or joint stiffness.
However, the Ribnjak Polyclinic, as a pioneer in the application of various revolutionary methods, has included in its offer the latest technology for the treatment of hallux rigidus – the installation of artificial cartilage CARTIVA! Namely, artificial cartilage is implanted in the thumb joint in place of its own damaged cartilage and completely takes over the role of that tissue. This type of treatment enables the disappearance of pain, the return of the full range of motion in the thumb joint and, finally, the full return to daily activities.
For a pain-free life.
Your Polyclinic Ribnjak