Hallux Rigidus - also known as arthritic big toe or simply 'stiff big toe' - can quite literally be a 'real pain' for people who suffer from it. The condition affects the joint at the base of the big toe and can make everyday activities such as walking, climbing stairs or bending down to pick something up excruciatingly painful.
As the condition is a form of degenerative arthritis, it will not get better on its own, in fact it is likely only to get worse over time. There are many non-surgical treatments that will help with the condition - generally a combination of anti-inflammatory medication and correction of any contributing mechanical factors such as 'overpronation' (where the foot is not immediately underneath the leg but splays out a little to the outside from the ankle when walking or running).
For some patients these non-surgical treatments will not help, in which case surgery is the next option. There are currently three surgical options...
- Removal of bone spurs and a section of the bone in the foot (to give the big toe more room to bend). This is called 'cheilectomy'.
- Fusion of the bones in the big toe. This removes the pain but the toe will not be able to bend at all after the procedure. This is called 'arthrodesis'.
- Joint replacement. This is where the big toe joint is replaced with an artificial joint. This is called 'arthroplasty'.
The good news is that there is now a new surgical option, called Synthetic Interposition Arthroplasty, where a newly developed type of synthetic material that mimics the function of the cartilage in the big toe joint is used to replace the natural cartilage tissue that has deteriorated.
Called 'Cartiva', this material is a 'biocompatible organic polymer', so not only is it suited for medical uses, it shares some of the essential properties of natural cartilage itself, particularly the need for a hard-wearing but smooth surface that allows the bones on either side of the joint to move together without a lot of friction. The component itself is about the size of a jelly bean.
Early clinical study results* indicated that patients receiving the Cartiva implant had a 93% reduction in pain, a 168% improvement inability to perform sports activities and a 65% improvement in day-to-day activities.
And having a Cartiva implant does not prevent a patient from having further surgery if this is required at a later date.
It is still early days for Cartiva, but if trials continue to show good results for the implant, it may not be too long before we see Cartiva implants in other joint surgery, including knee surgery and hip surgery. Watch this space!
*the MOTION Clinical Study involving 236 patients in a randomised trial across the UK and Canada.
For more information view Cartiva Great Toe Arthroplasty.