Big Toe Fusion Works and Adjacent Joint Wear Doesn't Seem to Matter

Adjacent joint arthritis is a big problem with ankle fusion, so why not with first MTP fusion?

The study: Radiographic changes vs. patient outcomes

In an exploratory study published last month, 77 patients were followed for nearly nine years. Radiographic arthritis progression was significant in all adjacent joints, most notably the interphalangeal joint (66 of the 77 cases). The tarsometatarsal, naviculocuneiform, and talonavicular joints also showed measurable degenerative changes. 

Despite these widespread radiographic findings, clinical outcomes remained strong: 91% of patients reported good or excellent satisfaction, with high functional scores across all measures. Joint wear didn't correlate with pain, alignment, or patient-reported outcomes.

Takeaway

MTP1 fusion delivers durable, excellent long-term results. The x-rays may look concerning over time, but patients largely don't feel it.