Arthroscopic Management of Disorders of the First Metatarsal–Phalangeal Joint
Arthroscopic surgery is one of the basic types of procedures in orthopaedic surgery. In the 1980s, there was a drift toward performing arthroscopic procedures on smaller joints.1–4 Although nowadays arthroscopic surgery of the knee, shoulder, elbow, ankle, and wrist have become routine procedures, arthroscopy of the first metatarsophalangeal (MTP-I) joint has received scant attention5 and has scarcely been reported in articles. Watanabe1 was the first to describe an arthroscopic procedure of the big toe in 1986. In 1999, Frey et al.6 reported that arthroscopic surgery of the MTP-I was still a developing procedure with a grey area for application. We published our first 27 MTP-I joint arthroscopic procedures in 1998, and, in a further publication, we reported the most important indications: osteochondral defect, dorsal impingement, and infectious arthritis.7 Currently, we lack evidence based on long-term follow-up studies on arthroscopic surgery of the MTP-I joint. After all these years, the procedure is still considered investigational. Although the arthroscopic procedure of the MTP-I joint is technically feasible and amenable for arthroscopy, the procedure is dependent on the skills of the surgeon. In this chapter, we describe the basic anatomy of the joint, the indication, the arthroscopic procedure, and the outcome.
KeywordsProximal Phalanx Metatarsal Head Osteochondritis Dissecans Arthroscopic Procedure Longus Tendon
- 1.Watanabe M, Ito K, Fuji. Equipment and procedures of small join arthroscopy. In: Watanbe M, editor. Arthroscopy of small joints. NewYork: Igaku-Shoin, 1986Google Scholar
- 2.Lundeen R. Arthroscopic approaches to the joints of the foot. J Am Podiatr Med Assoc 1987; 77:41–55Google Scholar
- 3.Richard O, Lundeen D. Review of diagnostic arthroscopy of the foot and ankle. J Foot Surg 1987; 26:33–36Google Scholar
- 6.Frey C, Van Dijk C. Arthroscopy of the great toe. AAOS Instr Course Lect 1999;48:343–346Google Scholar