Breakthrough Treatment for Big Toe Joint Arthritis

When arthritis develops in the big toe joint it can eventually damage the cartilage, causing pain, stiffness, swelling and, over time, can severely limit motion.

Until recently, the most common options for these patients were joint fusion or joint replacement.

Now, we have a solution, which was approved by the FDA this year, that allows for a quicker recovery with less risk, and leaves the door open for future options should there be a need.

The new Cartiva implant is a synthetic implant that replaces the damaged cartilage surface of the big toe. After reviewing the Cartiva literature and FDA medical report, I became very excited about this option and introduced it to my patients, who welcomed the opportunity to forgo a joint fusion procedure to get relief.

The Cartiva replacement is made of a soft polymer and molded to form a slippery, durable implant. It is inserted during a 20- to 35-minute outpatient procedure performed under anesthesia, which is often combined with a regional foot anesthetic.

To insert the implant, we make a two-inch long incision along the top of joint, known as the first metatarsophalangeal joint. Next, a small portion of bone is drilled to fit the Cartiva implant. We place the implant in the space we’ve created and close the incision with some stitches. No cement or glue is required to keep it in place, and patients are able to get up and walk immediately following the procedure.

For many patients, full weight bearing is possible immediately. Others may require guarded weight bearing, which involves wearing a surgical shoe and using a cane, crutches or a walker if the toe is sore. Seated range of motion exercises begin at once and most patients do not require physical therapy.

Based on fusion data, Cartiva patients experienced 93 percent less pain and improved their range of motion by at least 50 percent over standard treatment. That’s a significant benefit.

For those few patients for whom Cartiva fails to deliver the desired long-term results, our other options, such as fusion or joint replacement, are still available to us.

Big toe arthritis is no small matter. Since the Cartiva implant’s approval, I have enjoyed performing these successful implant insertions. Ask your doctor if the Cartiva implant is right for you, or call 219-738-6670 for more information.


Mark Jones, DPM, is a Methodist Physician Group foot and ankle surgeon. For an appointment, request an appointment online or call 219-738-6670.

Author
Dr. Mark Jones Dr. Mark Jones, DPM with the Methodist Physician Group in Merrillville, IN specializes in all things podiatry: diagnosis and treatment of conditions that affect the foot and ankle. Dr. Jones underwent training at the William Scholl College of Podiatric Medicine with honors in clinical studies. He went on to complete his surgical residency training, acting as chief resident in his section. He received national recognition after obtaining advanced training in a complex nerve surgery.

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