QUESTION 1 OF 2
A 46-year-old man presents with pain in the right 1st metatarsal phalangeal joint (MTPJ). He recalls a rugby injury to the joint 20 years ago. On examination he has moderate pain on end range of motion, reduced range of motion (10o dorsiflexion, 50o plantar flexion) and pain on axial loading of the 1st MTPJ. Radiographs demonstrate around 40% joint space narrowing with dorsal osteophyte on the metatarsal and phalanx. He has failed conservative treatment and still wishes to play rugby. What is the most appropriate treatment?
QUESTION ID: 49