Hemiarthroplasty vs. Fusion for Hallux Rigidus: Which Option Is Right for You?

Posted May 13, 2025 in Hallux Rigidus

5 Min Read:

Struggling with stiffness or pain in your big toe? You may be dealing with hallux rigidus, a common type of arthritis that affects the base of the big toe joint. This condition can make everyday activities, from walking to yoga, painful and frustrating. In this blog, we’ll explore big toe fusion, a well-known solution for advanced arthritis, and introduce an exciting alternative that helps preserve your natural movement and keep you active and pain-free.

What Is Hallux Rigidus?

Hallux rigidus means “stiff big toe,” and refers to a form of big toe arthritis characterized by pain, swelling, and limited motion in the MTP joint, or metatarsophalangeal joint. The MTP joint is where the base of the big toe meets the rest of the foot.

Hallux rigidus symptoms include:

Pain on top of the big toe joint, or deeper in the joint
Pain that is worsened when walking, climbing stairs, or bending the big toe
Stiffness or “stickiness” in the joint
Difficulty bending the big toe
Swelling around the big toe
A bony lump, or bunion-like bump, on the big toe joint
Numbness or tingling along the inner edge of the big toe, caused by bone spurs

Hallux rigidus is the second most common condition affecting the MTP joint, after bunions (hallux valgus). When non-surgical treatments like shoe modifications, anti-inflammatory medications, or orthotics no longer help, it may be time to consider hallux rigidus surgery.

What Is Big Toe Fusion?

Arthritis can wear down the cartilage that cushions a joint, causing the bones to rub against each other. Over time, this becomes increasingly painful as the joint suffers damage. Big toe fusion, or arthrodesis, is a surgery that removes damaged cartilage from the joint and permanently fuses the bones together.

This surgery provides pain relief and is a permanent solution for patients with advanced arthritis. However, it often restricts how much you can move your big toe, which can change how you walk and limit activities like kneeling, squatting, or lunging. It involves a longer recovery and may require a patient to rely on specialized footwear afterward.

Ultimately, while fusion is great for pain relief, if you’re hoping to bend your toe again, wear shoes with reasonable heels, practice yoga, or chase after grandkids, there may be a better option: hemiarthroplasty.

What Is Hemiarthroplasty with a Hemi-Implant?

Hemiarthroplasty means to replace half a joint (“hemi-” means “half” and “arthroplasty” translates to “joint creation,” implying a new joint), and is a lesser-known but powerful alternative to fusion. In this procedure, only the damaged portion of the big toe joint is resurfaced and replaced with a sleek, contoured hemi-implant, such as the BioPro® hemi toe implant.

Think of it as a mini big toe joint replacement that maintains the toe’s natural movement while relieving pain. This approach has been successfully implemented in larger joints like the hip (hence the term “arthroplasty”), but in this case, it’s tailored for the toe.

Why Choose Hemiarthroplasty Over Joint Fusion?

Hemiarthroplasty has been around for decades, but lost visibility when big toe fusions began to gain popularity. Now, it’s making a strong comeback thanks to modern implant designs and a growing recognition of how important joint motion is for long-term mobility.

Hemiarthroplasty offers numerous advantages:

Preserves Natural Motion: Maintains the ability to bend the big toe for activities like walking, squatting, lunging, or even athletic movement.
Supports a Natural Gait: Helps you maintain a healthy, natural walking pattern without the compensations that often develop after fusion surgery.
Promotes Long-Term Mobility: Keeps the big toe functional, supporting better balance, movement, and overall foot health over time.
Smaller Incision, Faster Recovery: A minimally disruptive approach that often leads to quicker healing and less downtime.
Durable, Lasting Results: Modern implants are designed for strength and longevity, helping patients enjoy long-term pain relief and improved function.

Who Is a Good Candidate for Hemiarthroplasty?

Hemiarthroplasty is well-suited for:

Patients with moderate to severe hallux rigidus, but still some remaining cartilage
Anyone who wants to preserve joint motion
People with active lifestyles who don’t want the limitations of fusion

If you want to do lunges at the gym, hold a downward dog, wear stylish shoes, or simply walk without stiffness, big toe fusion might not be your best fit. Instead, a big toe implant could be the more functional option.

There Are Alternatives to Big Toe Fusion

If you’re looking for toe fusion alternatives, hemiarthroplasty with a hemi-implant is a straightforward procedure worth considering. While some patients may qualify for total joint replacement, hemiarthroplasty often strikes the perfect balance between maintaining motion and ensuring durability. It’s a solution that works with your body, not against it.

Whether you’ve been told you need a big toe fusion or you’re still exploring hallux rigidus surgery options, don’t overlook this highly effective, motion-saving procedure.

Struggling with Big Toe Pain in New York City? Explore Motion-Preserving Options Today.

At Chelsea Foot and Ankle, our providers specialize in the full range of foot and ankle medicine. To experience our comprehensive care and receive a tailored treatment plan, schedule a consultation with us today. Use our online contact form or call us at (646) 929-4149 to get started.