1st MTP Joint Decompression Osteotomy Surgery
1st MTP Joint Decompression Osteotomy Surgery in Hawaii
A 1st metatarsophalangeal (MTP) joint decompression osteotomy is a surgical procedure used to treat early to moderate arthritis of the big toe joint (hallux rigidus) in patients who wish to preserve joint motion. The procedure works by shifting pressure away from the damaged portion of the joint to reduce pain and improve function.
This surgery is typically considered for patients who have persistent pain with walking or push-off despite non-surgical treatment, but who still have some preserved joint cartilage and motion.
How Surgery Is Performed
A decompression osteotomy involves making a precise cut in the first metatarsal bone and shifting it slightly to reduce pressure across the arthritic portion of the 1st MTP joint. The bone is then stabilized with screws while it heals.
By altering joint mechanics, the procedure reduces joint contact forces during walking and push-off while maintaining motion of the big toe.
Goals of surgery include:
Reducing pain caused by joint overload
Preserving motion of the 1st MTP joint
Improving push-off during walking
Delaying progression of arthritis and need for joint fusion
Recovery After Surgery
Recovery following a 1st MTP joint decompression osteotomy is structured but generally faster than joint fusion procedures.
Typical recovery progression includes:
Protected weight bearing in a postoperative shoe or boot
Gradual progression to full weight bearing as bone healing occurs
Physical therapy focused on restoring toe motion, reducing stiffness, and normalizing gait
Transition to regular footwear over several weeks
Most patients return to normal daily activities within weeks, with continued improvement in comfort and function over time.
Risks and Considerations
As with any surgical procedure, there are potential risks. These may include infection, delayed bone healing, stiffness, hardware irritation, incomplete symptom relief, or progression of arthritis over time.
A decompression osteotomy is not appropriate for advanced arthritis with severe cartilage loss. Careful patient selection is important to optimize outcomes and preserve long-term joint function.
Office Location
30 Aulike St. Suite 201
Kailua, HI 96734
Contact Information
scheduling@windortho.net
(808) 261-4658
Surgical Facilities
Castle Medical Center
Windward Surgery Center
