A first MTP joint fusion permanently stiffens a worn big toe joint to give reliable, lasting pain relief. It is the definitive solution for advanced arthritis and allows a return to walking, running and impact sport, though the joint no longer bends.
When is big toe fusion considered?
Fusion is considered when big toe arthritis is advanced, pain is present with most activity or at rest, and joint-preserving options such as cheilectomy are unlikely to give durable relief.
Can I avoid surgery?
What happens during the procedure
The worn joint surfaces are prepared so the bones can heal together
The big toe is positioned for comfortable walking and shoe wear
Small screws and/or a plate hold the joint while it fuses
The wound is closed and the foot is protected in a post-operative shoe or boot
Recovery timeline
- First 2 weeks — rest, elevation and wound care
- 6–8 weeks — X-rays check early bone healing and walking increases
- Around 3 months — most people are in normal shoes
- 4–6 months — return to gym work, running or impact sport if fusion is solid
Risks & complications
Risks include infection, delayed union or non-union, hardware irritation, transfer pain under the lesser toes and stiffness in nearby joints. The fused joint itself no longer bends.
Costs & insurance
Self-pay consultations are £250 (new) and £175 (follow-up). The procedure price is confirmed after your consultation. We are recognised by all the main insurers including Bupa, AXA Health, Vitality, Aviva and Cigna.
Questions & answers
Many people return to running and impact sport once the fusion has healed, usually around 4 to 6 months.
Most people walk comfortably once recovered because the toe is fused in a functional position for push-off.
High heels are not usually possible after fusion because the big toe joint no longer bends upward.
Yes. The operation is designed to make the joint one solid, pain-free unit.
