Surgical Management of Failed First Metatarsophalangeal Joint Arthroplasty.

This article describes the etiology, clinical presentation, surgical management, and outcomes for treatment of the failed first metatarsophalangeal (MTP) joint arthroplasty. Failure following implant arthroplasty typically creates large osseous deficits and surgical management can be difficult. Salvage arthrodesis provides reliable joint stability while maintaining hallux length. Outcomes following conversion of a failed MTP joint arthroplasty to MTP joint arthrodesis have demonstrated consistent pain relief and high satisfaction: however, high rates of complication and nonunion have been reported. Bone graft may be necessary to fill large voids in the joint. Other revision options for failed arthroplasty have been described, but outcomes remain inconsistent and varied. Ultimately, conversion to MTP joint arthrodesis is the recommended intervention for treatment of the failed MTP arthroplasty implant, providing sufficient stability and pain relief.

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Disclosure M.E. Easley: Exactech, Inc: IP royalties; Paid consultant; Paid presenter or speaker; Research support. IFFAS: Board or committee member. Journal of Bone and Joint Surgery - American: Editorial or governing board. Paragon28: Paid consultant; Paid presenter or speaker. Saunders/Mosby-Elsevier: Publishing royalties, financial or material support. Springer: Publishing royalties, financial or material support. Treace Medical: IP royalties; Paid consultant; Paid presenter or speaker. Wolters Kluwer Health - Lippincott Williams & Wilkins: Publishing royalties, financial or material support. A.T. Anastasio: QPIX Solutions – Paid consultant. I. Shaffrey has nothing to disclose.