MPJ Arthrodesis
New Orleans, LA
New Orleans, LA
Hallux rigidus—often called a “stiff big toe”—is a painful, progressive form of arthritis that affects the joint at the base of the great toe. Over time, cartilage loss and bone spurs can make it difficult to bend the toe, causing pain with walking, standing, or even wearing shoes.
At New Orleans Podiatry, we specialize in first metatarsophalangeal (MTP) joint arthrodesis, also known as first MTP joint fusion. This advanced procedure permanently stabilizes the joint surfaces of the big toe, relieving pain while preserving proper balance and strength in the forefoot.
Board-certified foot surgeon Dr. Edward Lang has extensive experience with first MTP joint arthrodesis as well as fusion of other joints of the foot when needed. His use of advanced fixation constructs, often combining compression screws, locking plates, dorsal plates, and advanced BioCartilage® treatment, supports early weight bearing and strong, long-term bone healing.
With a compassionate approach and precision surgical technique, Dr. Lang has helped countless patients regain comfort, mobility, and long-term function—restoring not just the motion of their feet, but the freedom to move without pain.
Eliminates discomfort from hallux rigidus, arthritis, or hallux valgus by fusing the first MTP joint.
Restores proper alignment and balance using advanced fixation constructs such as compression screws and locking plates.
Many patients begin early weight bearing in a protective boot, thanks to secure internal fixation.
Typically completed in under 90 minutes as an outpatient surgical procedure.
A 1st metatarsophalangeal joint (MPJ) fusion—also known as arthrodesis of the big toe joint—is a surgical procedure commonly performed to treat hallux rigidus, a form of arthritis that limits movement and causes pain in the great toe.
During surgery, the surgeon removes the damaged joint cartilage from both sides of the joint. The toe is then properly aligned and stabilized. A combination of plates and screws is used to secure the first metatarsal head to the base of the proximal phalanx. This advanced fixation technique is designed to allow early weight-bearing and promote a faster recovery.
Joint fusion is commonly performed on the first metatarsophalangeal joint (proximal medial joint) of the big toe. However, it can also be performed on other joint surfaces throughout the foot affected by arthritis and degeneration. This can include the distal or proximal interphalangeal joint, metatarsal cuneiform joint, calcaneocuboid joint, or the subtalar joint. Dr. Lang uses precision diagnostic methods to locate the affected joints and recommend the best treating plan for your specific condition.
At New Orleans Podiatry, MPJ arthrodesis, also called first MTP joint arthrodesis, is an outpatient procedure and may be performed using general anesthesia or local anesthesia with sedation. Patients return home the same day of surgery with a supportive recovery plan in place.
During surgery, Dr. Lang removes the damaged joint surfaces of the metatarsal head and proximal phalanx, then aligns the toe to optimize walking mechanics and allow wearing shoes comfortably after recovery. The bones are secured with a compression screw and locking plate, creating a stable fixation construct that promotes early weight bearing and lasting stability.
This precise surgical intervention is designed to provide lasting pain relief, correct deformity, and restore function so you can return to your normal activities without the limitations of a damaged first MTP joint.
In Addition to Traditional Fusion Techniques, Dr. Lang offers advanced joint-preserving regenerative options for painful MPJ arthritis. These include platelet-rich plasma (PRP) to stimulate natural tissue repair, hyaluronic acid (HA) to improve joint lubrication and mobility, and alpha-2-macroglobulin (A2M) to help block the inflammatory enzymes that contribute to cartilage breakdown. These minimally invasive therapies can reduce pain, improve function, and may delay or even prevent the need for surgery, allowing many patients to stay comfortably active for longer.
Dr. Lang may recommend first MTP joint arthrodesis for:
By correcting damaged joint surfaces and restoring alignment, MTP joint arthrodesis can provide long-lasting relief and improved walking mechanics, allowing most patients to return to daily activities and wear shoes comfortably once recovered.
MPJ Arthrodesis has several benefits related to comfort and function:
You may be a candidate for first MTP fusion if you have chronic pain, stiffness, or functional limitation from hallux rigidus, arthritis, or severe hallux valgus deformity that has not improved with non-surgical treatments. It is also an excellent option for those with poor bone quality or osteopenic bone where joint-preserving techniques would likely fail. Dr. Lang considers your medical history, joint health, and lifestyle goals before recommending this operative treatment.
Patients return home the same day as surgery with detailed aftercare guidelines and ongoing support from Dr. Lang and his team. In many cases, weight bearing in a surgical boot begins within the first few weeks. The affected joints are supported by stable fixation constructs and precise fusion techniques. Stitches are usually removed at 2–3 weeks, and Dr. Lang will use X-rays to monitor bone healing. By 8–12 weeks, most patients are back to wearing shoes comfortably. Mild swelling may persist for several months, but stable internal fixation helps prevent postoperative complications and supports long-term success.
MPJ arthrodesis delivers long-lasting pain relief, restored stability, and improved function in the first metatarsophalangeal joint. Once bone healing is complete, most patients can walk comfortably, return to daily activities, and wear a wide variety of comfortable shoes without the pain of arthritis or deformity.
As the bones are brought into their final alignment, weight is distributed more evenly, protecting surrounding joints and reducing the risk of postoperative complications. Because the joint surfaces are permanently fused, results are typically long-lasting, with minimal risk of recurring hallux rigidus or hallux valgus. Many patients also report a dramatic improvement in quality of life, including walking longer distances, resuming exercise, and enjoying an active lifestyle without the burden of chronic joint pain.
Dr. Lang is a board-certified surgeon with vast experience in first MTP joint arthrodesis. His advanced joint preparation methods and high-quality fixation constructs ensure reliable fusion and excellent functional outcomes. Whether using compression screws with a locking plate or a dorsal approach with a dorsal plate, every first MTP joint fusion is performed with meticulous attention to detail, reducing the risk of excessive shortening, nonunion, or further operative treatment. Our patients benefit from personalized care, thorough follow-up, and surgical techniques designed to get you back on your feet comfortably and confidently.
Most patients are in a surgical boot for 6–8 weeks after MTP fusion, with gradual weight bearing as healing allows. Complete bone healing can take several months, but many people can resume the majority of regular activities by 8–12 weeks.
Yes. Once the MTP fusion is solid and swelling has decreased, most patients return to wearing shoes comfortably. Some can wear fashionable shoes or high heels, although extremely tight toe boxes may be uncomfortable.
Post-surgical discomfort is common but typically well-managed with medication, ice, and elevation of the operated leg. Many patients find that recovery pain is far less than the chronic arthritis pain they experienced before first MTP fusion.
No. The goal of first MTP arthrodesis is to permanently stiffen the MTP joint, eliminating painful motion. Nearby joints adapt, allowing you to walk, balance, and perform physical activities comfortably.
Most patients are able to return to low-impact activities such as walking, cycling, and swimming once bone healing is complete. High-impact activities, such as running or jumping, may be more challenging due to the first MTP joint being permanently fused, but many people adapt well with proper footwear and training modifications.
This rare outcome, called nonunion, can occur due to factors like poor bone quality or inadequate healing. Our use of stable fixation constructs and close follow-up minimizes this risk. If it does happen, revision surgery may be necessary.
No. MTP fusion is designed to permanently stiffen the first MTP joint. Once the joint surfaces are fused, they cannot be separated without revision surgery, which is rarely indicated unless there are significant postoperative complications.
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