In this episode of GaitKeepers Journal Club, Dr. Mark Prissel and Dr. John Thompson discuss their recent systematic review on fusion rates of the first metatarsophalangeal joint (MPJ) arthrodesis after failed implant arthroplasty. They delve into the importance of systematic reviews in foot and ankle surgery, the clinical implications of their findings, and the technical considerations involved in revision surgeries. The conversation also highlights patient expectations, surgical outcomes, and real-life case studies that illustrate the complexities of foot and ankle procedures. They discuss case examples with treatment tips and pearls. The episode concludes with insights on optimizing patient outcomes and the future directions of research in this field.