Motion Preservation and Arthroplasty (Joint Replacement) is now considered the Gold Standard treatment option for most articular joints. The idea of fusing a hip or a knee joint in the 21st century, as the primary surgical option would now be rejected by all modern orthopaedic surgeons around the world. Therefore, why are great toe patients not offered the same standard of choice and care as patients with arthritic hip or knee joints?

The principal reason, Fusion of the MTP joints has evolved as the Gold Standard treatment, is because all previous MTP implant systems have proven to be unreliable and fraught with failure. We believe that in the 21st century, arthroplasty of the MTP is a viable treatment option for Hallux Rigidus Gr. 2, 3 & 4 indications. Based on the evidence gleaned over nearly 20 years, we contend that ROTOglideTM now offers surgeons and suitable patients the option of a safe and effective arthroplasty procedure.

We contend that ROTOglideTM should be offered to patients along with the option of fusion with an evidence-based rationale so that patients are free to choose between a functioning MTP joint and a fused MTP joint.

Even though Fusion is generally regarded as the de facto Gold Standard treatment option for Hallux Rigidus Gr. 2, 3 & 4, it is worth pointing out that the published failure or revision rate for this treatment option varies between 5% and 20%, depending on the surgical approach adopted. The known causes for this failure rate being:


Hardware discomfort








The long-term published failure or revision rate with ROTOglideTM is around 7%.

Therefore, ROTOglideTM arthroplasty has generally proven to be safer and more effective than arthrodesis since its launch in 1999.

In the rare event of a ROTOglideTM failure, the joint can be fused.

Why Arthroplasty?

Retain Mobility in Great toe joint via a unique design that has stood the test of time and been clinically proven to be safe and effective over nearly 20 years.

Pros and Cons of Fusion


A proven clinical procedure for dealing with HR Gr. 2, 3 & 4 but with a published failure rate of between 5% and 20% depending on the chosen surgical approach.


Stiff joint preventing the wearing of moderate heels and converting an important joint in the fore foot into a frozen joint.

This is the only total MTP joint implant that allows constant adaption of the great toe towards the ground surface under stable conditions due to the rotation between the phalangeal implant and the meniscus.
Professor Hakon Kofoed
ROTOglide offers a practical and well-tested alternative to fusion for those patients wishing to maintain movement in their arthritic great toe.
Mr Patrick Laing & Mr. Chris Walker
The only total joint replacement with positive evidence regarding function and clinical outcome
Prof. Dr. med. Martinus Richter


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