First MTP Joint Arthrodesis for Advanced Cases If an osteochondritis dissecans lesion is encountered, microfracture can be performed to improve the chance of a better outcome. Occasionally a proximal phalangeal osteotomy (Moberg) is needed to improve dorsiflexion in conjunction with the cheilectomy.
In mild-to-moderate disease (grades 1-2), a synovectomy and cheilectomy can achieve good results, including reduced pain and increased dorsiflexion. While these methods can be effective in improving symptoms, especially in less severe cases (grades 0-1), surgical treatment remains a viable option for alleviating most symptoms when conservative treatment fails.
It can be classified both clinically and radiographically (grades 0-4) according to range of motion, degree of pain, dorsal osteophyte formation and joint space narrowing.Ĭonservative treatment consists of NSAIDs, orthotics with a Morton’s extension to restrict first MTP joint motion, rocker-bottom shoes, taping, activity modification and (rarely) corticosteroid injections. It typically presents with the classic findings of restricted dorsiflexion with pain, swelling and synovitis. Hallux rigidus, a deformity secondary to degenerative arthritis, is one of the most common conditions affecting the first metatarsophalangeal (MTP) joint. We do not endorse non-Cleveland Clinic products or services Policy Advertising on our site helps support our mission. Cleveland Clinic is a non-profit academic medical center.
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