First Metatarsophalangeal Hemiarthroplasty for Grade III and IV Hallux Rigidus

The BIOPRO (R) first metatarsophalangeal hemiarthroplasty is a reliable alternative to fusion of the first metatarsophalangeal for patients with grade III or IV hallux rigidus. The implant was introduced in 1952, and Townley reported 93% good or excellent results on 279 implants with an 8-month to 33-year follow-up. One hundred three first metatarsophalangeal hemiarthroplasties have been performed at our center over 4 years, and we report no cases of deep infection or loosening. Postoperative arthrofibrosis is the most common complication and is addressed with manipulation, which restores functional dorsiflexion. A structured postoperative physical therapy program is important to maintain range of motion and favorable outcomes. A prospective, long-term follow-up study is currently underway.