Foot & ankle · Minimally invasive

Minimally invasive big toe surgery (cheilectomy)

Minimally invasive first MTP cheilectomy uses the Stryker PROstep™ percutaneous system to treat hallux rigidus (big toe arthritis) by removing bone spurs through tiny incisions — a joint-preserving alternative to fusion for early- to mid-stage arthritis. Consultations with our fellowship-trained foot and ankle surgeons in 1–3 days, with surgery typically 2–4 weeks later. Most patients walk the same day in a post-op shoe, returning to comfortable footwear at 4–6 weeks and full activity over 2–3 months.

At Pathway, our fellowship-trained foot and ankle surgeons perform minimally invasive big toe surgery (cheilectomy). Consultations are available in 1–3 days, with surgery typically 2–4 weeks later.

Book a consultation (647) 799-3230

Most patients walk the same day
Joint-preserving alternative to fusion
Surgery in 2–4 weeks
No referral required

Patient putting on comfortable shoes after big toe surgery recovery

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Joint-preserving option

At a glance

Most patients walk the same day
Joint-preserving alternative to fusion
Surgery in 2–4 weeks
No referral required

The procedure

What is a cheilectomy?

A cheilectomy using the Stryker PROstep™ system is a minimally invasive procedure performed to treat arthritis and bone spurs at the big toe joint (hallux rigidus). The surgeon removes bone spurs and reshapes the joint surfaces to address movement and discomfort.

How the PROstep™ approach works

Precision decompression — performed through small incisions on the top of the big toe joint using specialized MIS instruments
Decompression approach — bone spurs are removed and the joint surfaces reshaped to address movement and discomfort
Soft tissue preservation — precise bone removal while minimizing disruption to surrounding tissues

Throughout the procedure, imaging guidance is used to confirm adequate decompression of the joint, with the goal of smoother joint movement.

Watch it work

The PROstep™ technique, demonstrated.

A visual guide to the Stryker PROstep™ minimally invasive approach used for big toe joint decompression.

Visual guide: PROstep™ technique

Patient considerations

Why choose PROstep™ cheilectomy?

Streamlined recovery

Smaller incisions and less tissue trauma are designed to support a return to normal footwear and activities.

Improved aesthetics

Incisions are often just a few millimeters long, resulting in minimal scarring compared to open procedures.

Joint preservation

The goal is to support movement and address discomfort while preserving your natural joint for as long as possible.

Technology information regarding the PROstep™ minimally invasive system is provided by Stryker Corporation. Individual results may vary.

Your surgeon

Our cheilectomy specialist.

Fellowship-trained surgeon expert in minimally invasive foot & ankle care.

Dr. Danny Arora

Minimally invasive foot & ankle surgery · Duke University fellowship trained

Dr. Arora is Duke University fellowship trained, specializing in minimally invasive hallux rigidus reconstruction and toe joint preservation.

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What if the arthritis is too advanced?

In cases of end-stage hallux rigidus where the joint space has significantly narrowed, a big toe fusion (arthrodesis) may be a more appropriate long-term solution. Your surgeon will use physical examination and X-rays to determine if joint preservation is still a viable option.

Learn about first MTP joint fusion

FAQ

Frequently asked questions.

Most patients can begin weight-bearing in a specialized surgical shoe immediately after the procedure. Return to comfortable sneakers typically occurs within 2 to 4 weeks. High-impact activities or restrictive footwear may take 6 to 8 weeks depending on individual healing.

A cheilectomy addresses the mechanical symptoms of arthritis by removing bone spurs (osteophytes) that limit motion. While it does not reverse the loss of cartilage, it is designed to preserve the joint and improve function—often delaying the need for a joint fusion for many years.

In cases of end-stage hallux rigidus where joint space has significantly narrowed, a big toe fusion (arthrodesis) may be a more appropriate long-term solution. Your surgeon will use physical examination and X-rays to determine if joint preservation is still a viable option.

No referral is required. You can book a consultation directly to discuss your foot concerns. Having recent X-rays available is helpful, but we can also facilitate new imaging if needed during your assessment.

Next step

Start your care journey.

Schedule a consultation to discuss your big toe arthritis and see if a minimally invasive cheilectomy is the right approach for you. No referral required.

Book a consultation (647) 799-3230

Minimally invasive big toe surgery (cheilectomy)