First Metatarsal Cheilectomy and Osteochondral Defect Treatments

  • Bryan Van Dyke
  • Terrence M. Philbin


Degenerative joint disease in the first metatarsophalangeal joint is a progressive disease ultimately leading to end-stage hallux rigidus. We commonly use the Coughlin grading system for hallux rigidus from grade 1 to grade 4. Bussewitz et al. showed successful results at 3-year follow-up with cheilectomy for grades 1, 2, and 3 hallux rigidus. More recent attention to treating focal cartilage defects of the first metatarsal head has also shown excellent results at 3-year follow-up. Identifying and intervening earlier in this disease can reduce pain, preserve function, and delay or prevent progression.


Hallux rigidus Osteochondral defect Cheilectomy Microfracture Cartilage allograft 


  1. 1.
    Coughlin MJ, Shurnas PS. Hallux Rigidus: grading and long-term results of operative treatment. JBJS. 2003;85:2072–88.CrossRefGoogle Scholar
  2. 2.
    Bussewitz BW, Dyment MM, Hyer CF. Intermediate-term results following first metatarsal cheilectomy. Foot Ankle Spec. 2013;6(3):191–5.CrossRefGoogle Scholar
  3. 3.
    Van Dyke B, Berlet GC, Daigre JL, Hyer CF, Philbin TM. First metatarsal head osteochondral defect treatment with particulated juvenile cartilage allograft transplantation: a case series. FAI. 2018;39(2):236–41.Google Scholar
  4. 4.
    Coughlin MJ, Shurnas PS. Hallux Rigidus: surgical techniques (cheilectomy and arthrodesis). JBJS. 2004;86(suppl 1, pt 2):119–30.CrossRefGoogle Scholar
  5. 5.
    Farr J, Tabet SK, Margerrison E, Cole BJ. Clinical, radiographic, and histological outcomes after cartilage repair with particulated juvenile articular cartilage: a 2-year prospective study. Am J Sports Med. 2014;42(6):1417–25.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bryan Van Dyke
    • 1
  • Terrence M. Philbin
    • 2
  1. 1.Summit OrthopaedicsIdaho FallsUSA
  2. 2.Orthopedic Foot & Ankle CenterWorthingtonUSA

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