CARTIVA® Implant For Big Toe Joint Arthritis

Your toes’ joints are uniquely designed for movement. Your big toe provides most of the forward force needed for walking and running. CARTIVA implants allow your joint to move how they are supposed to for maximum mobility and range of motion. CARTIVA can be a better alternative to joint fusion (another arthritis procedure) that locks the joint in place.

Osteoarthritis (also known as “OA”) is a type of arthritis that occurs when flexible tissue at the ends of bones (cartilage) wears down. Osteoarthritis is a disease that can cause pain, stiffness, swelling, and limit motion over time.

CARTIVA® Synthetic Cartilage Implant (SCI)

The CARTIVA SCI is a man-made (synthetic) implant made of a soft plastic-like substance (polyvinyl alcohol) and saltwater (saline). These materials are combined and molded into a solid, slippery, and durable implant. It replaces the damaged cartilage surface of your big toe.

The CARTIVA SCI treats painful arthritis in the joint of the big toe (first metatarsophalangeal joint). Arthritis of the big toe, also known as osteoarthritis or “OA”, is when the cartilage tissue located in the big toe joint is worn down, usually causing pain.

CARTIVA SCI replaces the damaged cartilage surface of the big toe. The implant is placed into the bone in your big toe to provide a new smooth, slippery surface in the joint. As a result, the CARTIVA SCI relieves the pain and stiffness in your big toe caused by the worn cartilage.

Are There Alternatives To Using The CARTIVA® SCI?

If other non-operative methods have not been successful at reducing your big toe arthritis pain, surgery will likely be recommended by your doctor. You can ask your doctor about any other possible surgical treatments for your big toe arthritis pain, including:

• Cheilectomy: Surgery that shaves bone from both the joint surfaces of your big toe and removes the diseased part of the metatarsal head.
• Hemi-arthroplasty: Surgery that replaces part of your joint with metal or plastic parts to serve as the new surface of the first metatarsophalangeal head.
• Total Joint Replacement: Surgery that replaces your joint with metal and plastic parts to replace both sides of the metatarsophalangeal (MTP) joint.
• Fusion (arthrodesis): Surgery where the two sides of the MTP joint are cleared of cartilage. The two bones are held together with plates and/or screws so that the bones grow together. CARTIVA has been shown to be a better alternative to joint fusion.

Your doctor will have more information on these options and other possible treatments, as well as the benefits and risks for each.

Procedure

Your doctor will give you instructions before surgery. Follow these instructions the day before the operation.

The surgery usually occurs without an overnight stay in the hospital and lasts less than an hour.

The procedure begins with a small (about 2 inches) cut at the top of your big toe joint. This opens the joint of your big toe. Then, the doctor uses special tools to remove the necessary amount of bone to make a hole for the implant. The CARTIVA implant is placed into the hole in your bone joint, providing a smooth, slippery, load-bearing surface. It stays in place without the use of cement or glue.

Once the CARTIVA implant is in place, your doctor closes the cut in your toe with sutures, applies any dressings, and finishes the operation.

AFTER SURGERY

Your doctor will give you instructions about what will help you recover from surgery. Follow them carefully. You can begin putting weight on your toe as soon as you feel ready and begin exercises that move your joint immediately following surgery. You may need the help of a physical therapist to help you walk smoothly and without limping during your recovery. Your doctor will check on your progress after surgery.

GLOSSARY

ARTHRODESIS: Joint is fused with plates or screws.

ARTHRITIS: Swelling (inflammation) of one or more of your joints. This can cause pain and stiffness that can worsen with age.

ARTICULAR CARTILAGE: A smooth, slippery, white tissue that covers the ends of bones at joints. Healthy cartilage in our joints makes it easier to move. It allows the bones to glide over each other with very little resistance. Articular cartilage can be damaged by injury or normal wear and tear.

CHEILECTOMY: A surgery that involves shaving bone from both the joint surfaces of your big toe and removal of the diseased part of the metatarsal head.

HALLUX VALGUS: Hammertoe that is bending of one or both joints of the second, third, fourth, or fifth (little) toes.

HEMI-ARTHROPLASTY: A surgery that implants a device to serve as the new surface of the first metatarsophalangeal head.

JOINT: The location where bones connect and bend.

METATARSAL HEAD: The surface of the metatarsal bone in the big joint of the big toe.

METATARSOPHALANGEAL JOINT (“MTP joint”): The joint where your big toe begins. It joins the metatarsal bone and the middle bone of the big toe (proximal phalanx).

TOTAL JOINT REPLACEMENT: A surgery that implants devices to replace both sides of the MTP joint.

CARTIVA® Synthetic Cartilage Implants (SCI) are performed by specially-trained surgeons. Contact one of these CARTIVA specialists at Florida Orthopaedic Institute.