Securing a Toehold Against Arthritis Pain

A new surgical approach may offer better outcomes for patients with hallux rigidus, or arthritis of the toe, according to Andrew Elliott, MD, orthopedic surgeon at Hospital for Special Surgery, New York. Commenting on the condition, Dr. Elliott said “…hallux rigidus (is) one of the most frequent arthritic problems we see as foot and ankle surgeons. It occurs when the cartilage in the joint starts to wear out, and it usually gets worse over time.” Among Elliott’s patients presenting with hallux rigidus were a husband and wife in their 60s, for whom pain and swelling had severely impacted their daily activities. Elliott performed a surgical implant of a material similar to that in contact lenses, called Cartiva, that is designed to mimic the natural cartilage once present in the joint. Unlike joint fusion, the current treatment approach, the implant procedure does not limit motion in the toe.

Elliott noted that patient selection is important to deriving good outcomes from the implant procedure. Good candidates for Cartiva are patients whose arthritis is advanced and not responsive to conservative pain management approaches such as anti-inflammatory medications. But the condition of bones in the joints should also be sufficient to support the implant, and the patient should still be capable of motion in the big toe. He commented, “In carefully selected patients, I’ve seen the synthetic cartilage work well. Many have gotten back to activities they enjoy. Still, we caution patients not to engage in intense athletics or exercises that put extreme stress on their toe to ensure that the implant will last.”

Read about the new procedure.

Other Categories:

• primary care