Cartiva: Toe Joint Replacement

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PITTSBURGH, Pa. (Ivanhoe Newswire) — For people with severe arthritis in their toe joints, surgery has been one of the only options to relieve chronic pain. Fusion is a last resort. Surgeons now have a new option to relieve pain and keep patients on their feet.

Logan Snyder was a standout high school athlete, racking up awards and landing a college softball scholarship. However, pain in her toes became unbearable.

Snyder told Ivanhoe, “Anytime that I would put weight on my toes, when they would bend back is when it would hurt, which is pretty much constantly.”

Doctors performed multiple surgeries to relieve pressure from what’s called Hallux Rigidis, a rigid big toe.

Victor Prisk, M.D., an orthopedic surgeon at Allegheny Health Network in Pittsburgh, Pennsylvania, said, “We see it a lot in people who are on the front of their toes, whether it’s dance, whether it’s gymnastics, whether it’s running.” (Read Full Interview)

Dr. Prisk knew that fusing the joint would eliminate the pain, but would also limit motion. Instead he recommended a newly-approved flexible toe joint implant called Cartiva.

Dr. Prisk detailed, “It’s made up of a material called polyvinyl alcohol. It’s very similar to the material that would be used to make contact lenses.”

Doctors open up the top of the toe exposing the head of the joint, then they insert the implant.

Dr. Prisk told Ivanhoe, “It almost acts like a bumper in your joint. Just like your cartilage would.”

Snyder felt the difference as soon as she started moving her big toe.

Snyder said, “The change is that I can feel how far back it can get. It’s crazy compared to other surgeries.”

Last year pain forced Snyder to quit softball. Now she’s working to get back in shape without pain.

“That’s what I’m aiming for, and I really hope to get there,” said Snyder.

The FDA approved Cartiva last July.  Dr. Prisk said it’s recommended for patients who do not have gout, and don’t have severe toe deformities.

Contributors to this news report include: Cyndy McGrath, Supervising and Field Producer; Milvionne Chery, Assistant Producer; Roque Correa, Editor; Kirk Manson, Videographer.

 

MEDICAL BREAKTHROUGHS – RESEARCH SUMMARY

 

TOPIC:       Cartiva: Toe Joint Replacement

REPORT:   MB #4225

 

BACKGROUND: Osteoarthritis is the most common type of arthritis that can affect any joint in the body. Bones become exposed and rub against each other when the cartilage wears down. The decrease of cartilage can lead to pain and limit the range of motion. Around 21 million Americans suffer from some type of osteoarthritis. The condition usually develops because of age (it affects older people), heredity, obesity, or an injury. Osteoarthritis starts slowly but worsens over time. One joint that can be affected by osteoarthritis is the toe; it can cause tenderness, achiness and joint pain when walking.
(Source: http://www.healthline.com/health/osteoarthritis/big-toe#Symptoms2 & http://www.webmd.com/osteoarthritis/guide/national-institute-arthritis-musculoskeletal-skin-diseases#1)

TREATMENTS: Different types of treatments exist to treat toe arthritis. These will vary depending on the severity of the pain and the overall health of the patient. Some home treatments include:

  • Over-the-counter pain relievers and anti-inflammatories
  • Ice packs
  • Choosing the right footwear. Avoid high heels, tight shoes, and pointy toe shoes.
  • Healthy diet since extra weight can stress the bones of the feet

Other forms of treatment include:

  • Special shoes
  • Steroids injected directly into the joint
  • Surgery can be performed in severe cases with a fusion procedure or an arthroplasty once other treatments have not lead to any results

(Source: http://www.healthline.com/health/osteoarthritis/big-toe#Treatments5 & Dr. Victor Prisk)

CARTIVA: The FDA has recently approved a new treatment, called Cartiva, for patients who suffer from osteoarthritis of the big toe. This treatment consists of using a hydrogel implant, which is made up of a material called polyvinyl alcohol (similar to the material used to make contact lenses) in order to act as a replacement for the arthritic joint tissue. The material of the implant mimics the density of a natural bone, unlike metal implants, which can damage the healthy bone or be absorbed by it over time. The implant is inserted in a hole that is drilled at the head of the joint in order to act like cartilage. Cartiva does not damage healthy bone, it is durable, and bio-stable, meaning that it will not degrade in the body. Furthermore, the implant can be replaced in the future, and if it doesn’t relieve the symptoms of the patient, the material allows for a conversion to a fusion procedure. Cartiva has had 96 percent success rate in the span of 5 years’ worth of data.
(Source: Dr. Victor Prisk & http://www.footankleinstitute.com/the-cartiva-implant-for-arthritis-of-the-big-toe-joint)

FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:

Candace Herrington

412-330-4439

Candace.herrington@highmarkhealth.org

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com

Doctor Q and A

Read the entire Doctor Q&A for Victor Prisk, M.D

Read the entire Q&A