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An estimated 40% of the US population have foot problems.
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Of all patients aged over 50 years, 2.5% report degenerative arthritis of the first metatarsophalangeal (MTP) joint, termed ‘hallux rigidus’. First MTP osteoarthritis is the most common arthritic condition in the foot.
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Progression of great toe arthritis is associated with pain and loss of motion. Non-surgical intervention begins with shoe modifications and orthotics designed to limit MTP motion.
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In patients with mild arthritis, operative procedures focus on removing excess osteophytes (cheilectomy) to prevent dorsal impingement with or without a concomitant osteotomy (Moberg) to improve or shift range of motion into a less painful arc.
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In patients with more advanced arthritis, operative management has centred on arthrodesis of the first MTP joint.
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A recent Level 1 study shows excellent function and pain relief with a small hydrogel hemi-implant into the metatarsal head
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Multiple joint-sparing procedures such as joint arthroplasty or resurfacing have been described with inconsistent results.
Cite this article: EFORT Open Rev 2017;2:13–20. DOI: 10.1302/2058-5241.2.160031
