An improved implant for use primarily within the first metatarsophalangeal joint. The implant includes an elliptical, concave, joint surface positioned on a stem and is designed to be placed into a prepared proximal face of the phalanx. The implant is sized according to the patient and may be provided in a number of standard incremental sizes. The improvements relate primarily to the structure, size, and position of the stem that extends into the phalanx to support the implant. The stem is off-set from a center axis of the elliptical joint surface. This off-center placement allows for a longer stem. Single deep indentations on each side of the stem facilitate retention within the bone. A size selection tool is provided to facilitate the selection and placement of an appropriately sized implant. The tool further provides a template for positioning and placing the stem in the phalanx. A method for sizing and selecting the appropriate implant, and positioning and fixing the implant as a partial joint replacement, especially for the first metatarsophalangeal joint, is also described.