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  • #2663
    Al O’Purinol

    My gout tophi have settled in both big toe joints. The left toe has
    erupted and broken through the skin. I am likely to have surgery to
    repair in a few weeks by cutting the toe open, cleaning out the joint
    and correcting the bone.

    To your knowledge, how successful is this

    Tophi Surgery

    Tophi Removal From Hand photo


    I’m sorry that your tophi have reached the stage where an operation is necessary.

    Removal is a fairly standard procedure, and is normally successful. My experience from friends tells me that the sooner it is done, the better, because tophi that have broken through the skin can become infected.

    As with any surgery, their is a risk that anesthetics can trigger a gout attack. I’m not an expert in this field, but I believe treatment with alkalizing medication before the operation can reduce the risk of this.

    Post operation, your priority should be lowering uric acid levels to below 6mg/dL to help dissolve any remaining tophi, and stop more forming.

    I know you have also asked about uric acid reducing foods, and I will address that in the gout diet forum. Please be aware that, at this advanced stage of gout, diet will not be sufficient to lower uric acid enough to prevent further tophi build up – see gout diet section for best explanations.

    You must get medication for this – traditionally allopurinol, but there are alternatives, with new uric acid lowering drugs slowly becoming available.



    Let us know how the surgery went.

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