Needing a new toe? It’s putty in doctors’ hands...
FOR those who curse their children’s play putty being trodden into the carpet, here’s a reason to think of it with some affection. An extraordinary cure for sore toes and thumbs has been made from virtually the same material.
The cylindrical-shaped Cartiva device is surgically implanted to replace toes and thumb joints damaged by osteoarthritis.
At just 1cm wide, it is a soft plastic material made from polyvinyl alcohol (PVA), saline and water (PVA is also used in play putty). It can resist compression and mimic natural cartilage. Once in place, it acts like a roller, with the end of the two bones gliding around it.
‘This implant keeps the joint working with minimum removal of bone and other tissue,’ says Dominic Nielsen, consultant orthopaedic surgeon at St George’s Hospital, London, who is leading one of the UK trials of the device.
‘The procedure takes 30 to 45 minutes, usually under general anaesthetic. The joint is exposed by making a small, 4cm to 5cm incision. The damaged cartilage is removed and replaced with the implant.
‘Once in place, it provides a smooth, loadbearing joint surface. It is held in place by the shape of the joint and sits there, enclosed in the joint space and preventing the bones rubbing.
‘We have performed the procedure on a dozen patients, and the results are good.’
And new trial results show the implant for thumb arthritis can be highly effective, too. Grip and pinch strength were significantly improved.
‘We are pleased with the early results,’ says Dr Gustavo Ruggiero, of the Beneficencia Portuguesa de Sao Paulo Hospital in Brazil.
More than a million people a year consult their GP in the UK about osteoarthritis.
Arthritis of the big toe is usually down to wear and tear at the base. One study reported that up to ten per cent of people under 34 are affected, rising to 44 per of over-80s.
Osteoarthritis of the thumb affects up to 12 per cent of adults and as many as a third of post-menopausal women. In the early stages, toe and thumb arthritis can be treated with non-invasive procedures. For toes, insoles can cushion tender areas. Anti-inflammatories, steroid jabs and physiotherapy are also available.