Objective To retrospectively assess the primary clinical results of a cohort of the first metatarsophalangeal joint replacement with double-stemmed hinge silicone implant.Methods A total of 12 patients (15 feet) received the joint replacement with double-stemmed hinge silicone implant.There were 2 males and 10 females with a mean age of 61.4 (range,56-75) years old.Of them,9 cases (11 feet) were hallux valgus with osteoarthritis; 1 case (2 feet) was rheumatic arthritis; 2 cases (2 feet) were traumatic arthritis.The subjective and objective results were evaluated during follow-up.Results All of the patients were followed up regularly with an average of 24.7 months,ranging from 12 to 38 months.Ten patients were completely satisfied with the operation; 1 patient showed partial satisfaction,and 1 patient was not satisfied because of the first matatarsophalangeal joint pain due to severe hy-perosteogeny surrounding the cut bone surface 3 years after the operation.Osteolysis around the implant occurred in 2 cases without clinical symptoms,and no special treatment was given.Conclusion The joint replacement is a preferable method in alleviating pain and improving walking function with proper indication.