Great Toe Arthritis (1st MTPJ OA)


Patients will have pain and stiffness of their big toe joint. There are often prominent bony lumps on the top of their foot (dorsal osteophytes).


Your GP should initially request these investigations:

Weight bearing foot X-ray (AP and lateral)

Your surgeon may also request the following investigations for more information or surgical planning:

MRI to look at chondral damage

Conservative Treatment

Initial treatment of Great Toe Arthritis (1st MTPJ OA) could include:

Orthotics with a rigid sole or Morton’s plate may provide symptomatic relief. Injections of corticosteroid and local anaesthetic may improve pain for a variable length of time.

Surgical Treatment

Surgical treatment of Great Toe Arthritis (1st MTPJ OA) includes:

Cheilectomy - removal of the dorsal osteophyte and dorsal part of the joint.

MTPJ arthrodesis (fusion) - stiffening of the joint

Condition specific risks include:

  1. Non-union
  2. Metalwork failure
  3. Metatarsalgia (pain under forefoot)

General risks of surgery include:

  1. Infection
  2. Damage to nerves/blood vessels
  3. DVT / PE (blood clots)
  4. Anaesthetic risks


Recovery from Great Toe Arthritis (1st MTPJ OA) surgery will include: