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First MTP Joint Replacement

What is first MTP joint replacement? 
The first metatarsophalangeal (MTP) joint is the big toe joint. First MTP joint replacement involves replacing damaged bone and tissue with metal or plastic.

What are the goals of performing first MTP joint replacement?
The primary goal of this procedure is to reduce pain. Additional goals include retaining motion and improving the position of the toe.

Why may this surgery be needed?
This procedure is used to treat hallux rigidus, or severe arthritis in the big toe joint. Patients may want to consider this procedure if they have chronic pain and loss of joint function between the big toe and the foot. To determine if this procedure is the proper treatment method, your doctor will perform an examination and order imaging tests to evaluate the severity of the condition.

When should this surgery be avoided?
Patients that should not be considered for this procedure include those with infection, vascular diseases, or allergies related to the implant materials. Younger patients and those with deformities or damaged skin around the joint may also want to refrain from having this procedure. Diabetes can pose complications in surgery and patients with diabetes should first consult their primary care provider. Excessive activity can cause the implant to wear out prematurely, so active individuals may be encouraged to consider other treatment options.

How is this procedure performed?
An incision is made over the joint, and the doctor removes the damaged joint surfaces, a small amount of bone, and any bone spurs present. The doctor then prepares the bone surfaces for the implant before precisely placing its components and closing the incision with stitches.

What happens after the procedure?
The toe and foot are dressed with gauze and tape, and the joint will later be moved slightly to prevent stiffness. Physical therapy may be prescribed to help with motion and increase strength at the joint. To reduce swelling, you will need to keep the operative foot elevated as much as possible. Stitches are typically removed 10 to 15 days post-surgery, after which you will need to wear a shoe with a hard sole.