TechniquesSurgical Strategies: Cement Spacer for Staged First Metatarsophalangeal Arthrodesis After Failed ArthroplastyO’Donnell, Seth W. MD*; Vaughn, Joshua J. MD†; Sangeorzan, Adam P. MD*; DeFontes, Kenneth W. III MD‡; Bluman, Eric M. MD, PhD§Author Information *Foot & Ankle Fellow, Brigham & Women’s Hospital §Harvard Medical School, Boston, MA †DownEast Orthopaedics, Bangor, ME ‡Towson Orthopaedic Associates, Baltimore, MD The authors declare no conflict of interest. Address correspondence and reprint requests to Eric M. Bluman, MD, PhD, Harvard Medical School, 1153 Centre Street, Suite 5-South, Boston, MA 02130. E-mail: [email protected]. Techniques in Foot & Ankle Surgery: December 2020 - Volume 19 - Issue 4 - p 225-229 doi: 10.1097/BTF.0000000000000252 Buy Metrics Abstract Revision arthrodesis following surgery for first metatarsophalangeal arthritis (hallux rigidus) is a complex problem. Failed implants, arthroplasty, primary fusion, or infection may result in bone loss with abnormal soft tissue tensions. This requires technically challenging revision surgery necessitating debridement of nonviable bone, culture, and bone grafting of resultant defects. We describe a 2-stage technique for first metatarsophalangeal arthrodesis in the setting of osteolysis, infection, or bone loss. This staged technique allows for the restoration of appropriate soft tissue tension through the use of a temporary cement spacer before structural grafting. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.