First introduced in 1985, arthroscopy of the first metatarsophalangeal joint (1 MTP) has garnered increasing interest over the past two decades. The applications of this technique have expanded significantly, encompassing the treatment of conditions such as hallux rigidus [1], hallux valgus [2], osteochondral lesions [3], synovitis [4], arthrofibrosis, sesamoid complex pathology, gouty and septic arthropathy [5], as well as proximal phalanx cysts [4]. While often employed as an adjunct procedure in conjunction with other osseous interventions, in certain cases, it serves as the primary surgery.

Despite numerous published studies describing the surgical technique and its application in various pathologies, only a limited few provide clinical or radiological outcome data. Consequently, there remains a dearth of evidence regarding the true efficacy of the technique, especially in cases where 1 MTP arthroscopy is the primary surgery. Therefore, the aim of this systematic review is to analyze studies presenting objectively measurable clinical outcomes of patients treated with 1 MTP arthroscopy as the primary procedure, stratifying results based on the indication pathology.