Osteoarthritis of the 1st Metatarsophalangeal Joint

This chapter presents a case scenario of a 45‐year‐old female patient with a painful 1st metatarsophalangeal (MTP) joint. Nonoperative management is the first‐line treatment for most joints affected by osteoarthritis (OA), including the 1st MTP joint. A single systematic review of levels I–IV evidence summarizes the vast majority of evidence on nonoperative treatment of 1st MTP OA. Physical therapy is mainstay in the treatment of most forms of OA. Arthrodesis and arthroplasty have been the primary treatment options for end‐stage 1st MTP OA that is not responsive to nonoperative or joint preservation treatments. All arthroplasty options are successful in achieving improvements in pain, patient‐reported outcomes, and patient satisfaction. Surgical procedures for 1st MTP OA are most often performed for middle‐aged patients, and thus rarely considered in the realm of sports surgery. The chapter also provides recommendations for implementing evidence‐based practice in the clinical setting.