Table 1 Eligibility criteria

1. Coughlin grade 3 to 4 hallux rigidus with near constant pain and stiffness at least at extremes of passive motion +/− mid range of motion pain, where conservative treatment measures have failed

Inflammatory arthritis

Active infection

Severe vascular or neurological deficit affecting the lower limbs

Hallux valgus angle >15°

Inadequate or poor quality bone stock

2. Aged 45 years or above

Any previous surgery to the first MTPJ other than a cheilectomy

3. Male or female

4. Able to give informed consent

Significant and symptomatic interphalangeal joint or sesamoid-metatarsal osteoarthritis