Current evidence on the safety and efficacy of metatarsophalangeal joint replacement of the hallux appears adequate to support the use of this procedure provided that the normal arrangements are in place for consent, audit and clinical governance.
Clinicians should ensure that patients fully understand the uncertainties about the place of this procedure in relation to alternative treatment options. Patients should be provided with clear written information and, in addition, use of NICE's information for the public is recommended.
Patient selection is important, and should take into consideration the likely intensity and duration of use of the joint based on the patient's activities and aspirations.
Further research will be useful in establishing the long-term outcomes of different types of prosthesis.