Surgical Outcomes Following First Metatarsophalangeal Joint Replacement: A Cohort Study

Background/Objectives: First metatarsophalangeal (MTP) joint arthritis is a debilitating condition often treated with arthrodesis or joint replacement. However, the effectiveness of MTP joint replacement has not been thoroughly researched. This study aimed to evaluate functional outcomes and complication rates following first MTP joint replacement over a maximum seven-year follow-up period. Methods: A retrospective cohort study of 60 patients (68 toes) who underwent MTP joint replacement was performed. Data were extracted from medical records and anonymised prior to analysis. The primary outcomes measured included functional improvement and pain relief (AOFAS). Results: Findings indicate significant improvement in mean active and passive range of motion (ROM), with a mean active ROM of 35 degrees and a mean passive ROM of 45 degrees from a pre-op ROM of 0-10 degrees. The overall complication rate was 20.58%, with 10 cases of persistent stiffness but no pain and four cases of continued post-operative pain that necessitated MTP arthrodesis. Patients reported a mean post-operative AOFAS Hallux MTP-IP score of 88, improving from a pre-op score of 35. Conclusions: Results suggest that first MTP joint replacement is associated with significant pain relief and functional improvement with acceptable complication rates over the study period.