Cartiva: A Revolution in Arthritic Toe Treatment
Craig J. Breslauer, M.D.
When advanced-stage arthritis starts to affect the big toe joint, it can hinder our ability to use the foot efficiently and limit our sporting, social and even everyday endeavors. In fact, the most frequent site of osteoarthritis (OA) in the forefoot is in the first metatarsophalangeal (MTP) joint, which is reported to affect one in 45 Americans over the age of 50.
Cartiva, a breakthrough new synthetic cartilage implant (SCI), is changing the game for toe arthritis sufferers. Recently, Craig J. Breslauer, DPM, FACFAS, CWS, a board-certified podiatrist at South Florida Orthopaedics & Sports Medicine, became the first physician in the state to perform the Cartiva implant surgery.
Until now, the “gold standard” for patients with arthritis in the big toe joint was fusion surgery, which caused a complete loss of mobility in the great toe joint. Remarkably, the Cartiva SCI is now allowing patients to recover full function of the foot with faster recovery times.
Symptoms of Big Toe Arthritis
The onset of symptoms of arthritis in the MTP joint can be subtle and can also come about as a result of an acute injury. Typical symptoms include:
- Joint pain when walking or running
- Joint inflammation / swelling
- Enlargement of the bone that rubs shoes
- Inflexibility and restricted mobility of the big toe
Conventional Treatment for MTP Joint Arthritis
Traditionally severe arthritis of the MTP joint was treated with fusion surgery, or arthrodesis. The damaged cartilage would be taken out and the joint secured in a stable position by pins, screws or a plate, allowing the bones to grow and fuse slowly together.
Although the procedure effectively eliminated the pain, it also restricted the mobility of the big toe to such a degree that patients were limited from engaging in many sporting and recreational activities such as jogging, dancing or skiing. Wearing many kinds of high-heeled shoes was also an impossibility in the past, but not with Cartiva.
What Makes Cartiva Different?
According to the FDA, the Cartiva synthetic cartilage implant is designed, approved and supported for surgical placement in individuals having degenerative arthritis in the MTP joint. The innovative implant is made of the same biocompatible material as contact lenses and was conceived to replace the damaged cartilage and imitate its natural characteristics.
Although previous implants have had mediocre results, the new state-of-the-art Cartiva implant is inserted as part of a concise 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 difficulties.
What to Expect from Cartiva Surgery
The implant operation is performed as an outpatient procedure that takes about 45 minutes to complete. To insert the implant, your surgeon exposes the big toe joint through a 4-5 cm incision. Following the removal of any bone growths, the injured cartilage is taken out and replaced with a specially-fitted Cartiva synthetic implant, providing a smooth, weight-bearing joint surface.
As opposed to fusion surgery, patients can begin putting full weight on the foot as tolerated and range of motion exercises can start immediately after surgery to prevent stiffness. Some swelling may persist for a few days after the procedure, but many individuals gain full freedom from their arthritis symptoms shortly after surgery.
Normal muscle discomfort may continue for up to 4-10 weeks afterward, depending on each patient’s unique health situation.