Surgery Versus Watchful Waiting for First Metatarsophalangeal Joint Osteoarthritis : A Randomized Controlled Trial
Primary result · Walking-related pain (NRS 0 to 10), observed meanResult — go to the resultAdjusted mean difference −5.0 points 95% CI −6.1 to −3.9Authors' conclusion
Among adults aged 40 years or older with painful hallux rigidus, first MTPJ arthrodesis provides a superior and clinically significant reduction in walking-related pain at 12 months compared with watchful waiting.
Study context
- Population
- Adults aged ≥40 years with radiographically confirmed (Coughlin-Shurnas grade I to III) symptomatic hallux rigidus for over a year and walking pain numerical rating scale (NRS) ≥4; tertiary care hospital orthopedic department, Finland89 completed 12-month follow-up
- Participants
- 90 adults
- Comparison
- First metatarsophalangeal joint (MTPJ) arthrodesis vs watchful waiting
- Arthrodesisn = 45
- Watchful waitingn = 45reference
- Primary endpoint
- Walking-related pain (NRS 0 to 10); prespecified MCID 1.7 points
- Follow-up
- 12 months
Methodological detailssingle-centre, parallel-group, superiority, 1:1 randomisation, Recruitment November 2021 to June 2024, Mean age 58.1 years
- Single-centre
- Parallel-group
- Superiority
- 1:1 randomisation
- Recruitment November 2021 to June 2024
- Mean age 58.1 years
Primary result
As reported in the abstract
Walking-related pain (NRS 0 to 10), observed mean
Adjusted mean difference
−5.0 points
95% CI −6.1 to −3.9
By group
Arthrodesis
1.3
mean
Watchful waiting
5.7
mean
Arthrodesisvs Watchful waiting
adjusted mean difference −5.0 points (95% CI −6.1 to −3.9)
Original publication
Surgery Versus Watchful Waiting for First Metatarsophalangeal Joint Osteoarthritis : A Randomized Controlled Trial. Ann Intern Med. Published 11 August 2026. doi:10.
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