First metatarsophalangeal joint arthrodesis versus arthroplasty for hallux rigidus

Maria Carla Hernández Martínez and Mariacarlahdez1996@gmail.com

SAP Podiatry, 2026

Abstract: Introduction: Hallux rigidus is the most common arthritic condition of the foot, and first metatarsophalangeal joint arthrodesis is regarded as the reference surgical treatment, at the cost of joint motion. Arthroplasty preserves motion but its durability remains uncertain. Methods: A PRISMA 2020 systematic review searched Scopus, PubMed, and OpenAlex from 2018 to 2026 for studies comparing or reporting arthrodesis and arthroplasty of the first metatarsophalangeal joint in adults with hallux rigidus. Screening was assisted by artificial intelligence and verified by a single reviewer. Risk of bias was assessed with the Newcastle-Ottawa Scale, and results were synthesized narratively by outcome. Results: Of 495 records identified, 223 were screened and 13 studies were included, comprising four head-to-head comparisons and nine single-cohort series. In comparative studies, pain and function improved to a similar degree after both procedures; one matched study favored arthrodesis for exertion pain (visual analog scale 11.8 versus 35.4) and revision rate (5.6% versus 16.6%). Arthrodesis nonunion ranged from 0% to 30%, and arthroplasty revision ranged from 0.9% to 16.6%. Conclusions: Arthrodesis offers the most durable and predictable outcome, whereas arthroplasty remains a motion-preserving alternative with acceptable function but a higher revision risk in selected patients.

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:cwf:podart:pod2026275

DOI: 10.62486/pod2026275

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