Long-term results of total joint arthroplasty and phalangeal hemiarthroplasty of the first metatarsophalangeal joint using the ToeFit Plus™ system

•Long term results of I.MTP joint replacement using ToeFit Plus™ system.•Promising short term results.•Similar results in groups of total and hemiarthroplasties.•High failure percentage of the ToeFit Plus™ system long term. This paper compares long term success rate of MTP joint replacement for hallux rigidus. We provide long term results of MTP joint replacement with the use of the ToeFit Plus™ System. Our group consisted of 19 total joint replacements and 12 hemiarthroplasties in 18 and 11 patients respectively, performed between 2005−2009. The average follow-up period was 12.2 years (range 9.8–13.7, SD 1.1) for total arthroplasty group and 11.1 years (range 9.5–13.9, SD 1.7) for hemiarthroplasty group. In all followed patients AOFAS score was calculated along with the range of motion assessment. Average AOFAS score improved from 37 preoperatively to 79 at the time of last follow-up in total arthroplasty group and from 45 to 86 in the hemiarthroplasty group, with consideration to the statistically considerable difference of both groups. The total range of motion improved on average from 14° to the current 32° in patients with total arthroplasty and from 15° to 32° with hemiarthroplasty. The total number of cases that required surgical revision was 7 (37%) in total arthroplasty group and 2 (17%) in hemiarthroplasty group. Due to the high percentage of failure that was shown in our long term results, we no longer utilise the ToeFit Plus™ System.