The pain in Beth’s big toe got to the point where she couldn’t even lie in bed with a sheet over her foot. Not only that, the chronic discomfort she felt prevented her from walking normal distances without excruciating pain.
At 52-years old, Beth’s primary goal was to salvage her active lifestyle and avoid the loss of toe mobility that usually accompanies traditional big toe joint fusion surgery. In order to do so, she sought out the expertise of Craig J. Breslauer, DPM, FACFAS, CWS, a podiatrist and board-certified in foot and ankle surgery at South Florida Orthopaedics & Sports Medicine, and the first physician in the state of Florida to perform Cartiva implant surgery.
“Now I can walk longer without pain,” Beth says. “I have an excellent range of mobility, and I’m able to wear flip-flops again.”
When arthritis advances to the point where much of the cartilage around the big toe joint has eroded, everything we do with our foot becomes increasingly tricky, from engaging in sports to walking, and even routine social and household activities. The first metatarsophalangeal (MTP) joint, or the big toe joint, is the most common area of the forefoot to be impacted by osteoarthritis.
“Big toe arthritis is extremely common,” says Dr. Breslauer. “I see it at least once a day and sometimes several times a day at different stages of severity among patients middle-aged and older.”
What is Cartiva?
A revolutionary new procedure for those suffering chronic big toe pain, Cartiva has emerged as the most advanced treatment for toe arthritis available today. Before Cartiva, the go-to option for patient and surgeons to correct arthritis in the big toe joint was fusion surgery. Although effective in alleviating the pain, the procedure created a complete loss of mobility in the big toe. Thanks to Cartiva and its breakthrough synthetic cartilage implant (SCI), patients regain full function of the foot with faster recovery times.
“I had bone spurs and arthritis in my big toe. I had throbbing pain that precluded me from even putting sheets over my foot in bed,” says Beth. “My condition was starting to impede my walking. I wanted to stay active, and I sought out Dr. Breslauer who recommended the new FDA-approved Cartiva implant procedure. It’s a gel implant that goes into the joint, and it acts as a silicone buffer so you have lubrication and the toe can move again.”
Although previous implants have had mediocre results, the new state-of-the-art Cartiva implant is inserted as part of a short process that favors quicker recovery, and preserves function of the big toe joint. It also allows for additional surgical treatment in the future to address any other difficulties.
Symptoms of Big Toe Arthritis
Symptoms of arthritis in the MTP joint typically develop gradually, but they can also come about from an acute injury. Common symptoms include:
- Joint pain when walking or running
- Joint inflammation and swelling
- Enlargement of the bone that rubs against shoes
- Loss of big toe function and mobility
If not treated early and effectively, arthritis of the big toe can lead to pain and disability in other parts of the body. As the pain worsens, patients will compensate by externally rotating the foot which can lead to premature knee and hip problems over time.
“I was getting to the point where I couldn’t walk for long periods of time without having bunion pain,” says Beth.
Cartiva implant surgery is done on an outpatient basis. The procedure takes roughly forty-five minutes to complete. To accurately place the implant, a surgeon will expose the big toe joint using a 2-3 inch incision. Any bone growths present will be removed, and the damaged cartilage taken out and replaced with a specially-fitted Cartiva synthetic implant that provides a fluid, weight-bearing joint surface. As opposed to fusion surgery, patients can walk out the door right after surgery and begin the rehabilitation process immediately.
“Dr. Breslauer scheduled my surgery quickly,” says Beth. “I chose to do it because it allowed me to alleviate the source of pain while maintaining the mobility of the toe socket.” Upon meeting Dr. Breslauer for the first time, Beth felt immediate confidence in him and was sure he was the perfect doctor for the job.
“As soon as I met Dr. Breslauer, I was impressed by his knowledge, experience, and the cutting-edge technology he had access to,” she says. “I felt I was in good hands, I had no concerns about his capabilities, and he had a great bedside manner. The whole staff was good all the way through.”
As opposed to fusion surgery, no bone healing is required after Cartiva implant surgery. Patients can begin putting as much weight on the foot as they can tolerate and start range of motion exercises right after surgery to prevent stiffness. The result is a recovery process that is much less onerous on the patient.
Some swelling may persist for a few days after the procedure, but many individuals gain full freedom from their arthritis symptoms shortly after surgery. Stitches are generally taken out after about twelve days, allowing patients to transition into comfortable footwear. “My biggest challenge now is finding comfortable shoes that fit well,” says Beth.
Normal muscle discomfort may continue for up to four to ten weeks after surgery depending on each patient’s personal and medical history. Studies have confirmed the durability of Cartiva implants over a five-year period, with zero material failures reported.
After a successful Cartiva implant procedure, Beth is now back to walking and living pain-free. “Now I can walk much longer than I could before, and I don’t have the swelling anymore,” says Beth. “I would highly recommend it.”