First Metatarsophalangeal Joint Arthrodesis Eases Painful Hallux Rigidus

THURSDAY, Aug. 13, 2026 (HealthDay News) — For adults aged 40 years or older with painful hallux rigidus, first metatarsophalangeal joint (MTPJ) arthrodesis offers a superior reduction in walking-related pain compared with watchful waiting, according to a study published online Aug. 11 in the Annals of Internal Medicine.

Mikko Miettinen, M.D., from the University of Helsinki and Helsinki University Hospital, and colleagues compared first MTPJ arthrodesis to watchful waiting for reducing walking-related pain in symptomatic hallux rigidus at 12 months after randomization in a single-center, controlled trial. Ninety patients aged 40 years or older with radiographically confirmed (Coughlin-Shurnas grade I to III) hallux rigidus with symptoms over a year and a walking pain score of 4 or higher on a numerical rating scale were randomly assigned to surgery with first MTPJ arthrodesis using lag-screw and dorsal plating or to watchful waiting (45 to each group).

Eighty-nine patients completed the 12-month follow-up. The researchers found that the observed mean walking-related pain was 1.3 and 5.7 in the arthrodesis and watchful-waiting groups, respectively, at 12 months (adjusted mean difference, −5.0 points), exceeding the prespecified minimal clinically important difference and favoring arthrodesis.

“This trial offers support for arthrodesis as an important option for symptomatic hallux rigidus, one of the most common causes of foot pain and disability in adults, which affects daily mobility and quality of life,” the authors write.

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