Keller's arthroplasty at Exeter Hospital

What happens during Keller’s arthroplasty?

Keller’s arthroplasty is usually done under general anaesthetic. Your surgeon will make a small incision (cut) over the joint in your big toe. They will remove a small portion of the bone in the joint which increases the range of motion. They will replace the removed bone with soft tissue to create a “false joint”. Sometimes a pin will be used to set the joint. The pin is left sticking out of your big toe so that it can be easily removed in 3-4 weeks. The wound will be closed using stitches. Your foot will be wrapped in a dressing and you may be given a special surgical shoe to wear during your recovery.

Going home after Keller’s arthroplasty

You may be using a walker or crutches for the first 2 weeks following surgery. Take any pain medication as directed. Ice and elevate your foot as much as possible to control post-surgery swelling.

You may not be allowed full weight bearing for up to 10 weeks. Follow any activity instructions you are given when you are discharged.

You should keep your dressing clean and dry. You may need to return to us to have your dressing changed. After 10-14 days you will need to visit again to have your stitches removed. About 4 weeks after surgery you will need to come back for an x-ray. If your surgeon is satisfied with how your toe joint has set they will remove the pin. You can then wear a soft shoe such as a trainer.

It may take up to six-eight weeks before you can wear normal shoes again. Most people begin normal activities including exercises for range of motion after six weeks.

Most people may a good recovery from Keller’s arthroplasty. As with any surgical procedure there could be complications:

• Pain
• Bleeding
• Infection of the surgical site (wound)
• Scarring
• Blood clots (DVT - deep vein thrombosis)
  

Specific complications in bunion surgery may include:

• Nerve damage
• Continued swelling and pain
• Problems with bone healing
• Loss of movement in big toe
• Pain in the ball of the foot
• Bunion coming back
• Complex regional pain syndrome - a condition that causes long-term (chronic) burning pain in one of the limbs