Review Question - QID 211176

A 38-year-old male construction worker presents for a follow-up visit of a painful lesion with overlying skin changes over the proximal interphalangeal joint of the 2nd toe that has been present for over 3 years. He has tried wearing shoes with a high toe box, cushioned toe sleeves, and anti-inflammatory medications, but continues to experience discomfort that prevents him to work somedays. On physical examination there is PIP joint flexion with DIP extension that is not passively correctable. What is the best treatment option for this patient?