Implant arthroplasty of the first metatarsalphalangeal joint

Few topics in foot and ankle surgery incite as much debate as artificial replacement of the great toe joint. As with other implant arthroplasty procedures, such as the hip and knee, the first metatarsalphalangeal joint (MTPJ) has most assuredly had its share of failed designs. This article reviews the shortcoming of nonimplant procedures and discusses the advantage of the Arthrosurface system, a new implant that has been used in all major joints to replace degenerative areas and postpone the need for total joint replacement.