The humble joint at the base of your big toe may be beneath your notice, at least until it begins to hurt and feel stiff. One of the most common forms of arthritis can cause intense pain in this joint whenever you walk, stoop down or even just stand up.
For a long time, this condition, called hallux rigidus, was treated by fusing the joint together, permanently connecting the two bones at the joint. This surgery can reduce pain but results in permanent stiffness.
The U.S. Food and Drug Administration has approved a synthetic cartilage that allows patients to preserve their big toe’s range of motion. It’s called the Cartiva®Synthetic Cartilage Implant, and it acts like a cushion between the bones, simulating your natural cartilage.
Corey Rosenbaum, DO, an orthopedic surgeon who practices at AdventHealth Palm Coast, recently performed the first procedure with Cartiva in Flagler County. Considering its promise to be a game-changing treatment for a common and painful condition, Dr. Rosenbaum is eager to spread the word.
“Arthritis can wear away at the protective padding between the bones, but this new treatment gives us a chance to replace it,” Dr. Rosenbaum said. “It can bring excellent pain relief while preserving the joint’s range of motion.”
A major five-year study compared the effectiveness of Cartiva with the standard toe fusion procedure.
How is Cartiva better?
The study, presented in July at the annual meeting of the American Orthopaedic Foot and Ankle Society, presented long-term data on more than 100 patients who received the Cartiva implant. It found:
- Effective, long-term pain relief, with a 97 percent median reduction in pain
- Sustained improvement in function, with a 176 percent median improvement in sporting activities
- High rate of satisfaction, with 93 percent of patients saying they’d have the procedure again
The cartilage implant, made with the same material as contact lenses, looks like a tiny cylinder, either 8 or 10 millimeters long, roughly the width of a pencil. The procedure to insert the Cartiva implant is brief; it takes about 30 minutes and can be conducted in a same-day surgery center.
Walking and other weight-bearing activity is allowed immediately after surgery. Furthermore, if the surgery isn’t successful for any reason, fusion of the joint is still an option.
“Because it doesn’t involve cutting away any bone, if you need to, you can always convert it to a fusion without much difficulty,” Dr. Rosenbaum said. “This is an important bonus cause if metal replacements for the big toe joint fail, there might not be enough bone left for a standard fusion procedure.”
Though the speed of the procedure and the short recovery are helpful, the implant’s real benefits come in the preservation of the big toe’s range of motion. That might not sound like much — but it can make a significant difference in your daily comfort.
“Preserving range of motion in the big toe is important because without it, there is added pressure on other joints to compensate during walking or other normal activities,” Dr. Rosenbaum added.
Surgery with Cartiva implants isn’t without risk — like all foot surgeries, there is a chance of infection, blood clots, nerve damage, and other complications. The FDA has said these risks are not unreasonable and are comparable to typical treatments.
Cartiva is not for everyone with arthritis in the big toe, so you should talk to your doctor about whether it’s right for you.
AdventHealth’s experts know about the connections between our mobility and our health in body, mind and spirit. Helping patients stay active physically and socially are big parts of whole-person health.
To learn more or request an appointment at AdventHealth Palm Coast, visit our website or call Call386-586-1910.