What is Osteoarthritis (OA)?
Sometimes called degenerative joint disease or "wear and tear" arthritis, osteoarthritis (OA) is the most common chronic condition of the joints. It occurs when the cartilage or cushion between bones breaks down leading to pain, stiffness, swelling, and limitation of motion over time. In the foot & ankle, the big toe joint, also called the metatarsophalangeal joint or MTP joint, is the most common site of OA. Because this condition is progressive, motion at the affected joint becomes increasingly limited, making walking and even standing very difficult and painful.
Hallux rigidus, OA of the big toe joint, usually develops in adults between the ages of 30 to 60 years. Although osteoarthritis has no specific cause, several factors lead to the development of OA including excess body weight, injury to the joint, overuse, genes, and differences in foot anatomy, among others.
What is the current standard of care?
Fusing the bones together (arthrodesis) is often recommended and is the standard of care when the damage to the cartilage is moderate to severe. The damaged cartilage is removed and pins, screws, or a plate are used to fix the joint in a permanent position. Gradually, the bones grow together.
The main advantage of a fusion procedure is permanent correction in conjunction with pain relief. The major disadvantage is that with a fusion surgery, the motion at the joint is eliminated thereby limiting the ability to bend the toe at all.
What is the Cartiva® Synthetic Cartilage Implant?
The Cartiva Synthetic Cartilage Implant (Cartiva SCI) is a novel cartilage defect repair implant, which is man-made (synthetic) and is composed of a soft plastic-like substance (polyvinylalcohol) and salt water (saline). These materials are combined and molded into a solid and durable implant which has similar properties and water content of human articular cartilage. The high water content, similar to surrounding healthy cartilage, combined with its elastic and compressive mechanical properties, renders Cartiva SCI an ideal replacement for a joint's damaged cartilage. The material has also been shown to resist compression and shear with exceptional wear characteristics. The device is cylindrical in shape and is for use during a single surgical procedure, where its placement addresses focal articular defects. Joint resurfacing with Cartiva SCI is simple, does not require significant removal of healthy tissue, and typically results in nominal surgical trauma and rapid recovery.
What is Cartiva used to treat?
The Cartiva Synthetic Cartilage Implant is intended for use in the treatment of patients with painful degenerative or posttraumatic arthritis (hallux limitus or hallux rigidus) in the first metatarsophalangeal (big toe) joint with or without the presence of mild hallux valgus (bunion) deformity.
This is the only FDA approved alternative to joint fusion and its approval is supported by data from the MOTION clinical study, the largest prospective, randomized study ever conducted for arthritis of the MTP joint across 2 continents. The articles published in the prestigious Foot & Ankle International journal, both in 2015 and 2016, represent clinical data over a 5 year period with sustainable excellent results. Cartiva represents a significant advancement as a surgical option for the arthritic great toe joint.
We are pleased to provide this novel alternative to our patients. Our surgeons are among the first in New York to have successfully performed this procedure!
You may find the clinical studies here:
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