Can't help with the fusion, but surgeons always seem to want to cut you open afterall that's their joib! That obviosly may be the only option for a pain free toe joint, however a good pal of mine, a good runner, had long term big problem with his back several years ago. He was eventually listed for a spine fusion operation but changed his mind just before going into theatre, AND FLED THE HOSPITAL. He found alternative ways of managing his back and continues to be a very good runner.I have an arthritic big toe joint, so does my wife , we both get substantial pain relief just by using Voltarol Gel three times daily when reqired, although i appreciatte your problem may well be beyond this kind of help, but worth trying if not done so already.