Patient Age and Big Toe Arthritis

by Vince Vacketta, DPM

First metatarsophalangeal joint (MTPJ) fusion remains the gold standard for surgical management of hallux rigidus. While numerous reports demonstrate consistent improvements in pain and function with limited complications, little evidence guides the age-old question, "How young is too young for a first MTPJ fusion?"

Published just before the year’s end in Foot & Ankle International, Scheurer et al., provides surgeons with valuable long-term data regarding first MTPJ arthrodesis in the "young" population. In their cohort with a mean age of 43 years and mean follow-up of 14 years, the authors’ results not only demonstrated that first MTPJ fusion is a suitable option for the younger population, it demonstrated superior improvements in pain relief in the younger population when compared to the older cohort.

Takeaway

While still just a single study, this new long-term data not only validates the use of first MTPJ fusion in the younger population, it also demonstrates superior results in this younger cohort. Furthermore, this paper serves as an excellent resource to better educate patients, both young and old, on long-term outcomes in first MTPJ fusion.