Joint salvage procedures for failed first metatarsal phalangeal joint cheilectomy

Hallux rigidus is a painful arthritic condition of the first metatarsal phalangeal joint. For over 40 years, cheilectomy has been considered a first-line surgical treatment for mild and moderate cases of hallux rigidus. Despite successful results in the majority of cases, cheilectomy sometimes fails. Therefore, a number of revision surgical treatment options are available including joint-salvaging procedures such as repeat cheilectomy, dorsal osteotomy of the proximal phalangeal base, or interposition arthroplasty with allograft tissue. These revision surgical procedures will be discussed along with factors such as patient age, activity level, reason for primary failure, and severity of hallux rigidus that aid in decision-making.