Introduction: Midfoot arthritis can significantly impact one's quality of life, causing pain, stiffness, and limited mobility. While conservative treatments like medication and physical therapy can help manage symptoms, advanced cases may require surgical intervention. Adductoplasty, a surgical procedure aimed at addressing midfoot arthritis, has gained attention for its effectiveness in restoring function and reducing pain. In this blog, we'll delve into what adductoplasty entails, who can benefit from it, and what to expect during the recovery process. In addition it is helpful to know that the adductoplasty procedure in many ways is similar to the Lapiplasty procedure and in some cases the 2 procedures can be combined.

 

What is Adductoplasty? Adductoplasty is a surgical procedure designed to treat midfoot arthritis by realigning the bones in the midfoot region. It specifically targets the midfoot joints, such as the 2nd and 3rd metatarsal cuneiform joints (also known as the tarsometatarsal joints or TMT joints), which are commonly affected by arthritis. The goal of the adductoplasty procedure is to correct deformities, alleviate pain, and improve joint function and address arthritis joint pain.

 

Who Can Benefit from Adductoplasty? Adductoplasty is typically recommended for individuals with moderate to severe midfoot arthritis that hasn't responded adequately to conservative treatments. Common symptoms that may indicate the need for adductoplasty include persistent pain, stiffness, swelling, and difficulty walking or bearing weight on the affected foot.

 

The Procedure:

 

1. Preoperative Assessment: Before undergoing adductoplasty, patients undergo a thorough preoperative assessment, including imaging studies like X-rays or MRI scans to evaluate the extent of arthritis and deformity.
2. Anesthesia: Adductoplasty is performed under general anesthesia or IV sedation type anesthesia, depending on the patient's health and surgical preferences.
3. Incision and Access: The surgeon makes an incision on the affected foot to access the midfoot joints. Minimally invasive techniques may be used to minimize tissue damage and promote faster recovery.
4. Bone Realignment: Using specialized instruments, the surgeon realigns the bones in the midfoot to correct deformities and restore proper joint alignment. This will involve removing damaged cartilage or bone spurs.
5. Stabilization: Additional procedures like joint fusion are necessary to stabilize the joint and promote healing.
6. Closure and Recovery: Once the procedure is completed, the incision is closed, and the foot is bandaged. Patients are monitored in the recovery room before being transferred to a hospital room or discharged home, depending on the surgical plan.

Recovery and Rehabilitation: The recovery timeline for adductoplasty varies depending on the individual and the extent of the procedure. However, here are general guidelines:

 

• Postoperative Care: Patients are advised to keep the foot elevated and apply ice to reduce swelling and discomfort.
• Weight-Bearing: The surgeon will provide instructions on when and how much weight can be placed on the foot. Crutches or a walking boot may be recommended initially.
• Physical Therapy: Rehabilitation typically involves physical therapy to improve strength, flexibility, and mobility. Patients learn exercises to restore function and prevent stiffness.
• Follow-Up Visits: Regular follow-up visits with the surgeon are essential to monitor healing, address any concerns, and adjust the rehabilitation plan as needed.

 

Benefits of Adductoplasty:

 

• Pain Relief: Adductoplasty can significantly reduce pain and discomfort associated with midfoot arthritis, allowing patients to engage in daily activities more comfortably.
• Improved Function: By correcting deformities and realigning the bones, adductoplasty improves joint function, enhancing overall quality of life.
• Long-Term Results: Many patients experience long-lasting benefits from adductoplasty, especially when combined with postoperative rehabilitation and lifestyle modifications.

 

Conclusion: Adductoplasty is a valuable surgical option for individuals suffering from midfoot arthritis, offering pain relief, improved joint function, and enhanced quality of life. If you're considering adductoplasty or exploring treatment options for midfoot arthritis, consult with a qualified orthopedic surgeon to determine the best course of action based on your specific needs and goals. With proper care, rehabilitation, and follow-up, adductoplasty can pave the way for a more active and pain-free lifestyle.

 

If you have any questions or would like a consultation please call 425-391-8666 and make an appointment online.

Dr. Timothy Young
Foot & Ankle Surgeon
Issaquah's Top Podiatrist

Arthritis of the big toe or sometimes called hallux limitus or hallux rigidus involves degenerative arthritis of the big toe.  It often presents as pain and swelling in the big toe and even limited range of motion.  Patients often have a history of any injury like a turf toe type incision where the majority of the time this is genetic in origin.  This typically starts from an anatomical misalignment or elevated first metatarsal where long-term jamming of the joint and pain and swelling begins.

The treatment options from a surgical aspect involves joint preserving procedures.  Joint sparing procedures involve trying to increase the life of the joint.

Joint sparing procedures typically have consisted of cleaning up the joint which is very commonly called a cheilectomy. This can be done for early type arthritis.  This has all been considered were course of early intervention and has had great outcomes.

Joint destructive procedures typically involve the use of implants or fusion.  Implants of the big toe joint have fallen out of favor and are not utilized by many physicians. The stays and fusion continues to be the mainstay.  However there are other options that become available, depending on the patient's needs.  There are some physicians that advocate what is called an interpositional arthroplasty which seems to work well and provides some space in the joint to provide cushioning.

If you have big toe pain I am happy to help make an appointment at our office and we can see whether conservative or surgical options are warranted. Give us a call today at 425-391-8666 or make an appointment online today. 

Sincerely,

Brandon Nelson 
Board-Certified Foot and Ankle Physician and Surgeon