The treatment of advanced hallux rigidus remains controversial. Only a few studies have analyzed the short and mid-term results of metatarsophalangeal (MTP) joint arthroplasty to treat patients with advanced hallux rigidus. We present the short-term follow-up results of patients who underwent MTP joint arthroplasty. We reviewed the medical records of 15 consecutive patients (3 males and 12 females) who had had grade 3 or 4 hallux rigidus diagnosed according to the Coughlin and Shurnas classification. The age range at surgery was 44 to 74 (mean 61.6) years. The mean follow-up period was 21.7 (range 18 to 28) months. The mean change in the overall American Orthopaedic Foot and Ankle Society Hallux-First Ray scale score was from 26.9 +/- 2.3 preoperatively to 78.7 +/- 8.8 postoperatively (p < .005). The mean change in the overall visual analog scale score was from 8.3 +/- 0.8 preoperatively to 1.7 +/- 0.7 postoperatively (p < .005). The mean preoperative first MTP joint range of motion was 22.3 degrees +/- 7.7 degrees (range 15 degrees to 45 degrees), which had increased to 77 degrees (range 65 degrees to 90 degrees) at the final follow-up visit. No patient required revision surgery or removal. These results indicate that for patients with advanced -stage hallux rigidus refractory to conservative treatment, total joint arthroplasty can lead to good satisfaction and good functional results in the short term. (C) 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.