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Great Toe Synthetic Cartilage Replacement (Cartiva)

Great Toe Joint Synthetic Cartilage Implant

Arthritis of the big toe is very common in our community across all ages and activity levels. The joint involved is called the 1st metatarso-phalangeal Joint.  Arthritis is a loss of normal cartilage. Cartiva is a relatively new Synthetic Cartilage Implant.  It has physical properties that are very similar to normal cartilage..

The most reliable procedure for arthritis has always been a fusion. A fusion of the joint is considered the ‘Gold Standard’ operation.

Fusion is a good operation but not perfect.  Fusion provides reliable pain relief but stops all movement of the joint. This effects a number of activities including wearing heeled shoes and sports.

Replacement of the joint in the past has been problematic. The implants have failed early and also compromised the bone. As a result, when the replacement failed, the fusion that was then needed was compromised. The damage to the bone  and the compromise of the ‘gold standard’ fusion meant that the implants were not used by most surgeons

Cartiva is a relatively new Synthetic Cartilage Implant.  It has physical properties that are very similar to normal cartilage. The clinical studies have shown that it provides equivalent pain relief to a fusion while preserving and improving motion.  Also there is no period of crutches and a faster recovery. The impant can take weight immediately.

Importantly: in the failures that have occurred the bone was not damaged so that fusion could be performed without compromise when needed.

The evidence that supports the use of the implant comes from 12 different hospitals in the U.K and Canada. It is level 1 evidence which is the highest level of evidence in surgery. A number of other studies have also been performed out to 5 years. Despite the strong evidence, the implant is still new and there  is a degree of risk with anything new in surgery. Likewsie the general risks of surgery are still present.

A patient of mine who had the implant was recently featured on Channel 7 news. Please note that the implant is for arthritis of the great toe only.