Dayton Daily News

New procedure for big toe arthritis helps regain mobility

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Most people don’t give a thought to the function of their toes until they suddenly find themselves unable to walk properly or wear their favorite high heels.

Gradual restrictio­n of this type of activity may point to big toe arthritis – or hallux rigidus, as the medical community refers to it. It may be surprising to learn that osteoarthr­itis of the big toe is one of the most common forms of arthritis, and while affecting a small area of the body, delivers a significan­t impact upon quality of life.

“Big toe arthritis is when a person loses the cartilage on both sides of their joint that is at the base of their toe,” said Michael Barnett, MD, an orthopedic surgeon with Premier Orthopedic­s, a Premier Health Specialist­s practice. “This can lead to pain, swelling, loss of function, inability to perform activities such as running and jumping, and can eventually lead to debilitati­on.”

Up until now, the most effective surgical treatment for big toe arthritis was fusing the joint that was causing the pain. This fusion procedure provides immediate relief, but can leave a person unable to naturally move their foot and limit their ability to engage in physical activity or wear fashionabl­e footwear, Dr. Barnett said.

However, new hope is available for sufferers that not only takes away the pain, but also helps an individual regain their quality of life. The new procedure, called the Cartiva synthetic cartilage implant, provides synthetic cartilage to the area where the natural cartilage was lost. The implant is made of the same water consistenc­y as real cartilage which means it provides similar shock absorption and durability as the body’s original cartilage.

“The Cartiva is a significan­t leap forward in what we have previously done for many reasons,” said Dr. Barnett, who was the first person in Ohio to perform this new procedure. “It has a two-year track record that shows pain, safety and functional­ity scores are the same as the industry’s gold standard – which was joint fusion. There is also a very low risk of implant failure, which could not be achieved through the use of former implants made of silicone or titanium.”

Individual­s who have moderate to severe hallux rigidus are good candidates for the Cartiva implant. These candidates may have significan­t thin- ning of the joint space, have developed bone spurs, have limited range of motion and significan­t debilitati­on from pain and swelling. The Cartiva implant is an option for those who have undergone more conservati­ve measures — such as the use of anti-inflammato­ries, motion restrictio­n devices in the shoe or Corticoste­roid injections — and have found no relief.

“The Cartiva is definitely exciting to me as an orthopedic surgeon because the last thing we want to do as physicians is limit a person’s ability to engage in physical activity,” Dr. Barnett said. “Once we start limiting a person’s motion of their joints it can lead to other health problems. The fusion procedure not only limits a person’s activity, but also can cause excessive loading on other joints. This is a procedure where we are keeping a person’s motion going.”

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