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This procedure is performed in instances where the total first metatarsal phalangeal joint is destroyed, particularly the head of the first metatarsal bone. If the cartilage on the first metatarsal bone is totally eroded and pitted, it cannot be salvaged.

By inserting a total implant you are creating an artificial joint and the goal of this procedure to reduce pain. Although a "new" joint has been implanted, in most cases there will still be limitation of motion to some extent, but hopefully no pain.

The inherent problem with total implants is that if they have to be removed because of infection or rejection of the implant, the surgeon is left with a big space and little options. In these cases the toe bone has to be fused to the metatarsal bone as there are no other options available.

I am not a big fan of first metatarsal-phalangeal joint fusions. The younger the patient and more active the patient, the more problematic the fusion becomes.

The ideal candidate for a complete fusion of the great toe joint is an older, sedentary individual.

pre-operative degenerated joint of foot

removal of arthritic joint

drill holes for Swanson total implant

Insertion of Swanson total implant

before and after Swanson total implant

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