N (2008) Resurfacing of the first metatarsal head in the treatment of hallux rigidus. Tech Foot Ankle Surg 7:31–40

Surgical techniques for the treatment of hallux rigidus have evolved during the past decade. Previously, main treatments were cheilectomy for earlier stages of hallux rigidus and resection arthroplasty or arthrodesis for ad-vanced stages. Although arthrodesis has been considered the ‘‘gold standard’ ’ for advanced hallux rigidus, in younger and more active patients, activity, functional, and shoe wear limitations are undesirable outcomes of this procedure. Alternative surgical procedures have been developed for advanced hallux rigidus, with vary-ing outcomes and complications. Endoprosthetic replace-ment, which has been well described in the past and revisited recently, has higher complication rates than more traditional approaches. Hemiarthroplasty using var-ious prosthetic resurfacings of the phalangeal base has been reported with variable success rates as well. Soft tissue interpositional arthroplasty has been shown to have inconsistent results and significant stiffness. The Arthrosurface HemiCAP prosthesis has been described for the treatment of full-thickness chondral and osteo-chondral defects of the shoulder, hip, and knee with high success rates to date. More recently, the technology was expanded to allow for metallic resurfacing of the first metatarsal head as an alternative technique with the potential to maintain motion and function. By using this implant alone or combined with soft tissue interposi-tional arthroplasty, or proximal phalanx osteotomies, even severe forms of hallux rigidus can be treated. Dur-ing the past 30 months, the authors have treated more than 100 patients with hemiarthroplasty of the first meta-tarsophalangeal joint using the HemiCAP prosthesi