Arthritic Metatarsophalangeal Joint

Arthritis of the lesser metatarsophalangeal joints, the joints of the ball of the foot excluding the big toe joint, most commonly affects the second metatarsophalangeal joint.

Reasons behind the development of arthritis include trauma, healed Freiburg’s disease and inflammatory joint disease to include rheumatoid arthritis.

Non-surgical management can include:

  • Steroid injections
  • Alteration of footwear
  • Activity modification
  • Insoles

Surgical management can include:

  • Removal of bony outgrowth around the joint and remodelling Joint replacement
  • Removal of the base of the toe (avoided if possible).

There are several joint replacements available, the indications for each of these are influenced by a person’s age and activity levels. Joint replacements for this condition include the Cartiva implant.

Arthritic second metatarsophalangeal joint with flattening of the metatarsal head and base of the toe bone (proximal phalanx), cyst formation and new bone formation on the sides of the metatarsal head. Overall the joint loses its normal appearance and appears more square.

Grossly arthritic second metatarsophalangeal joint associated with a large bunion and second toe deformity