【Abstract】 Objective To evaluate the effectiveness of lesion clearance combined with Bone cement technique for the treatment of tophi in first metatarsophalangeal (MTP) joint with metatarsal bone defect. Methods Between January 2017 and December 2019, 32 cases of tophi in the first MTP joint with bone defect were treated by lesion clearance combined with Kirschner needle and bone cement technique. All 32 cases were male. The average age was 47.3 years (range, 32-78years). There were 19 left feet and 13 right feet. The disease duration ranged from 3.5 to 16 years, with an average of 6.8 years. Preoperative uric acid value was (568.00±107.47) mmol/L, hallux valva angle (18.84±4.27)°, metatarsalis joint range (7.41±2.46)°, and visual analogue scale (VAS) score was (5.72±1.02) points. Results The incision primarily healed in 29 patients after operation. The skin necrosis at the edge of the incision occurred in 3 patient and recovered after symptomatic treatment. All patients were followed up 12-18 months, with an average of 15.9months. X-ray films showed that solid cement filling no separation and displacement。At last follow-up, metatarsalis joint range (17.72±4.27)°、VAS score was （1.84±0.77）, which were superior to preoperative scores, with significant differences(P<0.05)。The uric acid value was (568.00±107.47) mmol/L, hallux valva angle (18.84±4.27)°, which showed no significant changes compared with preoperative, and the difference was not statistically significant (P>0.05). Conclusion In the treatment of the first metatarsophalangeal joint tophi with bone defect by bone cement, the metatarsophalangeal joint can be preserved, the range of motion can be improved, the fusion of metatarsophalangeal joint can be avoided, and the metatarsophalangeal fracture caused by tophi erosion can be reduced, and a good clinical effect can be achieved.