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Abstract Objective To evaluate the short-term outcomes of the first metatarsophalangeal joint replacement and the first metatarsophalangeal joint fusion in the treatment of end-stage hallux rigidus.Methods From February 2015 to August 2016，27 patients (27 feet) were diagnosed with end-stage hallux rigidus and eligible to research standard.They were treated by the first metatarsophalangeal joint replacement or fusion，and their age ranged from 28 to 52 years old with an average age of (39.0±3.6)years old.Among them，the joint fusion group had 2 males and 10 females，and their age ranged from 30 to 52 years old，with an average age of (40.0±2.5)years old.Joint replacement group were consisted of 5 males and 10 females，and their age ranged from 28 to 52 years old with an average age of (39.0±3.4)years old.The outcomes were analyzed by the range of motion (ROM)of first metatarsophalangeal joint，Maryland score，and Visual Analogue Score(VAS) of the last follow-up and preoperation.Results All the patients were effectively followed up，and their follow-up times were 11 to 17 months with the average follow-up time of (14.0±2.7)months.There were no significant differences in follow-up time between the two groups (P＜0.05).In joint fusion group，the average Maryland scores were increased by 15.3 points and the average VAS scores were decreased by 4.4 points in the final follow-up，and the differences were statistically significant (P＜0.05).The joint range of motion were lost in the fusion group after the operation.All the patients in the fusion group obtained the fusion at the end of follow-up，and 4 patients had metatarsalgia and the pain was nearly disappeared after treatment by orthopaedic insoles.In joint replacement group，the average Maryland scores were increased by 20.2 points，the average VAS scores were decreased by 4.6 points，and the average ROM was increased by 40.1°in the last follow-up，and the difference were statistically significant (P＜0.05).All patients in the joint replacement group，there were no prosthesis adverse events in the last follow-up，and 1 patient suffered incision necrosis after surgery，and the wound healed after dressing.There were no significant difference between the two groups in preoperative average ROM，average VAS score and Maryland score (P＞0.05).The average Maryland score of the joint replacement group were higher than that of the joint fusion group at the last follow-up，and the difference were statistically significant between two groups (P＜0.05).There were no significant difference in VAS scores between the two groups at the last follow-up (P＞0.05).At the end of the follow-up，the joint fusion group lost the ROM，which could not be compared between groups.Conclusion The short-term outcomes of first metatarsophalangeal joint replacement and fusion were satisfied in the treatment of hallux rigidus，and the outcomes of first metatarsophalangeal joint replacement were better，but the long-term outcomes need to be further follow-up.
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