Summary: We should consider earlier treatment of degenerative changes and cartilage repair in patients with chronic pain in the first metatarsophalangeal joint- analogically as we do in the knee or ankle. Grade Iv chondromalacia may be successfully treated with arthroscopic micro fractures.

One of the most common disorders of the first metatarsophalangeal joint is hallux rigidus, which results in pain, deformity and limited range of motion. Once the osteoarthritis changes progress, arthrodesis or total arthroplasty might be indicated.
Very few studies focus on the effective treatment of the early stages of osteoarthrosis.
We included twelve patients with chronic pain within I MTP joints and X-rays with no abnormalities for this study. MRI of the forefoot was performed in all patients. Grade IV chondromalacia was diagnosed in all patients on the articular surface of the head of the I MTP.
All patients underwent arthroscopic debridement and microfractures.
Within two years of follow-up, all patients had good clinical outcomes, complete pain relief, and the subchondral bone oedema disappearance.
More detailed diagnoses, including MRI, should be considered in patients with complaints in the I MTP joint and normal X-ray. We should consider earlier treatment of degenerative changes and cartilage repair in patients with chronic pain in this joint - analogically as we do in the knee or ankle.

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Arthroscopic treatment of the early stages of the First Metatarsophalangeal Joint Results in Good Clinical Outcomes and Pain Relief in Two Years of Follow-Up

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Arthroscopic treatment of the early stages of the First Metatarsophalangeal Joint Results in Good Clinical Outcomes and Pain Relief in Two Years of Follow-Up

Arthroscopic treatment of the early stages of the First Metatarsophalangeal Joint Results in Good Clinical Outcomes and Pain Relief in Two Years of Follow-Up

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