In the past, joint replacement surgery of the first metatarsophalangeal (MTP) joint has had limited success for a number of reasons. Old methods were unsuccessful because the implant would become loose, wear down, or it didn’t provide sufficient range of motion in the toe. Because of this, many foot surgeons have opted for fusion operations when the joint has become arthritic. However, a new option may change all that.
Polyvinyl Alcohol Implant
The newest player in the arthritic toe surgery game is the polyvinyl alcohol (PVA) hydrogel implant. You may have heard of it by another name on television or in magazines – Cartiva. The Cartiva implant of a small disc of durable PVA hydrogel that has outperformed similar devices on the market. What’s unique about the implant compared to older implants is that the PVA implant resists compression and shearing, and it has exceptional wear characteristics.
Other benefits of the implant include:
- Does not require significant removal of healthy tissue
- Involves a minimally invasive procedure
- Quick recovery time
Long Term Success
One of the biggest concerns with previous big toe joint procedures was their inability to provide the patient with a viable long-term solution to their joint pain. However, the PVA hydrogel implant appears to show some promise in that arena as well.
A recent study examined the success of the surgery five years after the initial operation. 27 patients underwent the PVA joint operation, and their outcomes were tracked five years after the completion of the surgery. Researchers examined the toe’s range of motion, flexion angle, and the implant’s appearance using imaging techniques. After comparing that data to pre-surgical measurements, researchers uncovered that the PVA surgery patient experienced:
- An improvement in functional outcomes (range of motion, flexion, etc.)
- Significant decreases in pain levels
- Excellent implant survivorship
The vast majority of patients experienced these results, and only one of the 27 patients needed to have the implant removed and be converted to a standard fusion operation.
