Thirty patients who had 34 Bio-Action Great Toe Implants (four bilateral replacements) for symptomatic advanced degenerative changes in the first metatarso-phalangeal joint (MTPJ) were followed prospectively for an average period of 20. 7 months (range 8–32 months).

The age range of patients was between 38 and 72 years with mean age 55. 8 years. Majority of patients had either a Hallux rigidus (19/34 replacements, 56%) or hallux valgus with severe degenerative changes in first MTP joint (9/34 replacements, 26%). The scoring system designed by Kitaoka et al for the American Foot and Ankle Society, was adopted to assess the functional results. Patient satisfaction, length of stay, time to return to routine activities, footwear problems, x-ray appearances and complications were all assessed.

There was a statistically significant improvement in the range of motion achieved and Hallux MTP scale after the operation. (Paired samples test was significant at 5 percent level). There was a positive correlation between the patients’ satisfaction and Hallux MTP scale. However, there was no correlation between patients’ age and patients’ satisfaction. Similarly, there was no correlation between patients’ age and post operative Hallux MTP scale score. (Pearson’s correlation coefficients). There is statistically significant improvement in life style, foot wear requirements and functional abilities after the operation. The complications includedmetatarsal fracture during operation (l/34 replacements) in one case, four cases of superficial infection which resolved completely with a course of antibiotic and one case of aseptic loosening of the implant which was revised to a cemented implant. Two out of 34 replacements reported sustained transference metatarsalgia beyond 6 months post operatively. 72% of patients (24/34 replacements) considered the result of the operation to be excellent or good. Overall, the early functional results of this total joint system appeared to be satisfactory.