How To Treat Osteoarthritis Of The First MTPJ

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The author says the McGlamry elevator is “invaluable” in performing soft tissue release that minimizes dissection and trauma.
Given the difficulty of penetrating a sclerotic base,  using a 2.7 mm drill (as shown above) can help create a pilot hole in the center of the bone.
In comparing the pre-op view (left) and post-op implant placement (right), one can see the corrected hallux position and preserved toe length.
By Thomas Cusumano, DPM

Dr. Cusumano is a Fellow of the American College of Foot and Ankle Surgeons. He currently practices in Englewood, Fairlawn and Riverdale, N.J., and serves as a team physician/podiatrist for the athletic teams at Fairleigh Dickinson and Montclair State Universities.

Editor’s Note: For a related article, see “Titanium Hemi-Implant: A Vital New Solution For MTPJ Pain?” in the January 2001 issue of Podiatry Today or check out the archives at



1. Marcinko DE: Medical and Surgical Therapeutics of the Foot and Ankle, pp 423-465, Williams & Wilkins, Baltimore, 1992.

2. Gerbert J, Chang T: Clinical Experience with Two-Component First metatarsal Phalangeal Joint Implants. Implantable Biomaterials 12(3)403-413, 1995.

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