Lifetime cost-effectiveness of first metatarsophalangeal joint fusion using patient reported outcomes from National Foot and Ankle Registry data in the UK
1st MTPJ fusion is a highly cost-effective intervention for hallux rigidus, delivering clinically significant and durable improvements in quality of life at very low cost per QALY gained. This procedure provides greater value for money than many widely commissioned major orthopaedic operations, including hip and knee arthroplasty. Current NHS restrictions on access are not supported by health-economic evidence. These findings reinforce the essential role of 1st MTPJ fusion in value-based foot and ankle surgical care.
Authors
- Karan Malhotra (ORCID: https://orcid.org/0000-0001-7589-5310)
- David Townshend (ORCID: https://orcid.org/0000-0002-1384-4582)
- Edward V. Wood
- C.L. Wyatt
- Robert P. Clayton (ORCID: https://orcid.org/0000-0002-6910-3062)
- Nilesh Makwana (ORCID: https://orcid.org/0000-0003-0459-2405)
- Lyndon Mason (ORCID: https://orcid.org/0000-0002-0371-3183)
- Joel Humphrey
Institutions
- University of Liverpool (GB)
- Aintree University Hospitals NHS Foundation Trust (GB)
- Northumbria Healthcare NHS Foundation Trust (GB)
- Milton Keynes Hospital (GB)
- Robert Jones and Agnes Hunt Orthopaedic Hospital (GB)
- Royal National Orthopaedic Hospital (GB)
- Royal Liverpool University Hospital (GB)
- NHS Fife (GB)
- Countess of Chester Hospital NHS Foundation Trust (GB)
- Countess of Chester Hospital (GB)
- Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Trust (GB)
- University College London (GB)
Publication Details
- Journal
- The Foot
- Published
- 2025-11-21
- DOI
- https://doi.org/10.1016/j.foot.2025.102214
- Primary Topic
- Foot and Ankle Surgery
- Type
- article
- Field-Weighted Citation Impact
- 0.00