The First Metatarsophalangeal Joint: Updates on Revision Arthrodesis and Malunions

Abstract

First metatarsophalangeal joint (MPJ) arthrodesis procedures are a mainstay of forefoot surgery and are associated with high rates of patient satisfaction for addressing a multitude of first ray pathologic conditions. This procedure is often also used as a fallback option for the revision of poor outcomes after other surgical procedures involving the first ray. Despite its successes, there remain instances of complications that can develop after primary first MPJ arthrodesis. This article reviews first MPJ arthrodesis as a procedure for revisional surgery of the first ray, and potential surgical options after failed primary first MPJ arthrodesis.

Keywords: Arthrodesis; Critically sized defects; First metatarsophalangeal joint; Forefoot salvage; Fusion; Hallux rigidus; Hallux valgus; Revision surgery.