Great Toe Joint Replacement

Joint Replacement

The goal of Joint replacement ( arthroplasty)  is to maintain range of motion, relieve pain and allow return to activity. 

A recent implant termed Cartiva, made from Polyvinyl alcohol Hydrogel, aims to act as a spacer in the joint. This  stops the impingement or jamming of bone, allows a range of motion and provides pain relief. The rationale with this prosthesis is that it preserves bone and allows for revision to a fusion if it wears out.

This is a new prosthesis which has evidence for up to 5 years. The results from prospective randomised studies suggest that pain relief is similar to fusion, however up to 10% fail and require a fusion. As such consideration is required, taking into account the extent of arthritis, age, required function and the stiffness of the toe. An MRI can be helpful to determine suitability.

Post operatively patients can weight bear from the outset, with elevation for 2 weeks and then period of 6 weeks of gentle activities before increasing to normal activities. Swelling resolution can take 3 months.

Complications

These include less than 1% risk of wound-healing problems, infection and numbness in skin.  For Joint Replacement there is a 10% chance of incomplete pain relief or failure of the prosthesis requiring revision to a fusion.

Great Toe Joint Replacement

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