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New procedure for big toe arthritis helps regain mobility

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 thinning 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.”

Big toe arthritis is a common condition in older adults. Studies have shown that one in 40 adults over age 50 will develop the condition. The use of Cartiva allows older adults to stay active longer — something that is important in preventing disease processes that are common with aging, Dr. Barnett said.

Cartiva may also provide hope to the small percentage of younger patients who develop big toe arthritis due to overuse from sports and even activities such as ballet.

“We now have something to offer younger patients who have developed the condition from a traumatic injury or excessive use of the joint,” he said. “This will help keep them active longer and help avoid a fusion procedure.”

For more information on big toe arthritis or to find a Premier Health Specialists physician near you, visit www.premierhealthspecialists.org/ortho.

Premier HealthNet is one of the largest groups of pediatrics, family medicine, internal medicine, and urgent care practices in southwest Ohio. For more information, go online to www.premierhealthnet.com/news.

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