Failed Bilateral Total Silastic First Metatarsophalangeal Joint Implant Reconstructed with Osteochondral Allograft Implantation.

First metatarsophalangeal joint (MPJ) arthritis is a very common form of arthritis seen in the foot. Some signs and symptoms include pain, swelling, decreased passive and active range of motion, difficulty with shoe gear, and so forth. Surgically, options for alleviating symptomatic hallux limitus and arthritis fall into two broad categories: joint sparing and joint sacrificing. In this case study, we present a patient with a bilateral failed total silastic implant of the first MPJ and our proposed revision using an osteochondral bone allograft to fill the deficit left behind from silastic implant removal. The ability for immediate weightbearing and to perform this procedure bilaterally is an advantage to this surgical treatment option compared with other described revision techniques. Postoperatively, the patient has adequate range of motion and no pain when ambulatory. We believe this osteochondral allograft implant may be a viable option for revision first MPJ arthroplasty in select patient populations.