Total joint arthroplasty of the first metatarsophalangeal joint is an acceptable modality of treatment for hallux rigidus. We set out to evaluate the early outcome of ceramic/ceramic (MOJE) prosthesis, in the treatment of painful hallux rigidus.

Between March 2000 and June 2002, 13 patients (14 implants) with painful hallux rigidus were treated with ceramic/ceramic (MOJE) prosthesis. The hallux meta-tarsophalangeal-interphalangeal scoring scale, by the American Orthopaedic Foot and Ankle Society, was used to assess these patients, pre-operatively and at follow up. A total score of 100 is possible in a patient with no pain, full range of MTP joint movement and good alignment.

The average follow up was for 12 months. At six months, 12 patients had no pain post operatively. The average AOFAS score pre-operatively was 43.07, compared to 95.28 post-operatively (p= 0.0001). Ten of the patients subjectively described the out come of the procedure as excellent. Two patients described it as satisfactory. One patient with significant hallux valgus pre-operatively, developed subluxation of the prosthesis at 6 months. At revision, the prosthesis was noted to be loose and a distraction arthrodesis was carried out. Pre-operatively, all patients had a combined dorsiflexion and plantarflexion range of between 30 and 74 degrees. Post operatively this was improved to greater than 75 degrees in 10 patients. Seven out of the eight female patients were able to wear fashionable foot shoes with high heels comfortably. Twelve of the patients experienced audible squeaking, which improved after six months. One patient developed a superficial infection, which was treated successfully.

The ceramic/ceramic (MOJE) total arthroplasty gave excellent results in 77% of patients. Patients were happy with the fact that they could continue wearing fashionable shoes. The early outcome is encouraging, with a statistically significant improvement in the AOFAS scoring system.