Long-term Survival of the TOEFIT Plus First-Metatarsophalangeal Joint Replacement for End-Stage Hallux Rigidus

Mean Manchester-Oxford Foot Questionnaire score at the latest follow-up telephone consultation was 7.4 (range 0-59, SD 14). Twelve of 70 joints were revised to arthrodesis because of phalangeal component loosening, with 24 joints lost to follow-up. Best-case scenario showed 81% survival at mean 11.0 years, whereas worst-case scenario showed only 48.2% survival. The mean age of patients who had revision surgery was 62.5 years (range 51-73, SD 6.9). The mean age for nonrevised patients was 62.0 years (range 42-82, SD 9.0), with no significant correlation between patients' age and the implant longevity or revision. In the first 5 years following TJR, there was a 15% chance of revision.ConclusionRevision was mainly caused by phalangeal component loosening. Even in the best-case scenario, the 19% revision rate at 10 years is concerning, but the potential 52% failure rate in worst-case analysis is unacceptably high. We recommend discontinuing the use of the ToeFit Plus arthroplasty.