First Metatarsophalangeal Joint Arthrodesis with Calcaneal Allograft for Failed Joint Arthroplasty

First metatarsophalangeal joint (MTPJ) arthrodesis is a powerful surgical option for treatment of hallux rigidus, hallux valgus, and revisional first MTPJ surgery. Joint arthroplasty serves as an alternative to arthrodesis for patients who want to preserve joint motion. However, joint arthroplasty has a high rate of failure and can lead to significant bone loss, which makes revisional surgery more challenging. In this study, we present the use of a calcaneal bone block allograft and bone marrow aspirate for fusion of a first MTPJ with a previously failed joint implant. Radiographic fusion was achieved after 6 weeks and ambulation has remained pain-free at 1 year follow-up.