First Metatarsophalangeal Joint Arthroscopy in Patients With Hallux Valgus

Purpose: The purpose of this study was to evaluate the results of first metatarsophalangeal joint (MTPJ) arthroscopy in patients with hallux valgus. Methods: The arthroscopic findings of 121 first MTPJ arthroscopies were analyzed together with the radiologic assessment of hallux valgus angle, sesamoid position, and foot type. Results: In those patients with first MTPJ pain, pain is associated with metatarsophalangeal compartment synovitis and cartilage lesions. Of those with first MTPJ pain, 90% had complete or significant relief of the joint pain after arthroscopic synovectomy. Conclusions: Metatarsophalangeal compartment synovitis and cartilage lesions are significantly associated with first MTPJ pain in patients in hallux valgus. Synovitis and cartilage lesions of the metatarso-sesamoid compartment are not associated with first MTPJ pain. Patients with hallux valgus can complain of first MTPJ pain without any bunion pain. First MTPJ arthroscopy is an effective tool to control MTPJ pain when conservative management fails. Level of Evidence: Level III, retrospective comparative case-control study.