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Refusing Fusion: An Alternative Treatment For Big Toe Arthritis

June 26, 2017  |  F. Ray Nickel, MD

Did you know that the most common arthritis of the foot occurs at the joint at the base of the big toe? Many people think that they just have bunions, but over 2 million Americans actually suffer from osteoarthritis of this joint. The arthritis is caused by a gradual wearing away of the lining cartilage, which allows the bones to glide smoothly over each other, and eventually results in bone grinding against bone. For years, the only surgical solution was to fuse the bones together. However, this process locks the joint into place which affects the ability to push forward when walking as well as the height of the shoe heel which can be worn.

Thankfully, there is a new technique now on the market that provides much better results and faster recovery times than fusion. It is called Cartiva. Released in the United States in 2016, Cartiva is an implant the size of a jellybean which fits into the space between the worn-out area and minimizes the contact and constant irritation from the two rough surfaces. In other words, it acts as an extremely durable shock absorber between the bones.

With Cartiva, patients retain motion of their big toe while being able to perform activities like walking, exercising and even putting on shoes pain-free. The procedure is done through a relatively small incision on an outpatient basis and typically takes only half an hour to complete. Immediately after surgery, patients are able to put weight on their foot as well as begin to perform joint movement exercises.

One of the largest studies ever performed in North America was for Cartiva and it showed remarkable results. After five years of study, there was a 92 percent patient satisfaction rate. The implant is made to last a lifetime, but if it needs to be removed or replaced, it does not prevent salvage with a fusion.

Symptoms of osteoarthritis of the big toe include tenderness, achiness and pain at the joint, and occasionally, a burning sensation. Pain in the toe is common after long periods of standing and walking. The pain is made worse with narrow shoes, which cause pressure over the enlarged joint area, and also when wearing high heels.

If you or someone you know suffers from these symptoms, please contact your local Ventura Orthopedics office today to schedule an appointment. Our Foot & Ankle specialists -- Dr. Nickel (West County) and Dr. Rearick (East County) -- would love to talk with you to see if Cartiva is the best solution for you.

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