HemiCAP Toe Implants

Screen Shot 2014-03-27 at 9.06.21 AMScreen Shot 2014-03-27 at 9.06.16 AMThe Arthrosurface HemiCAP® joint restoration technology was designed for patients who want to alleviate their joint pain but who also want to continue working and maintaining their active lifestyles. Many patients are looking for a treatment option that “bridges the gap” between a cheilectomy and a fusion plate or total toe replacement.

ToeDFThe Toe HemiCAP® implant system is designed to match the shape and contour of the individual patient’s cartilage surface. It is a contoured cap that replaces the area of damaged cartilage and is designed to protect the remaining (healthy) cartilage in the joint. Instead of a one-piece implant with a stem built in, the HemiCAP® is two components. It consists of a cap and screw that mate together via morse taper lock. Stemmed implants have been shown to loosen, whereas the HemiCAP® screw system has been a stable construct with no reported loosening over the last 10 years. The idea behind the system is to prevent further damage to the joint while maintaining the patient’s native anatomy and motion.

Arthrosurface ToeMotion™ System

ToeMotion™ System

For patients with extensive damage on both sides of the joint, Arthrosurface® also provides a total toe restoration called the ToeMotion™ system. This consists of the Toe DF HemiCAP® implant on the metatarsal side of the joint and a metal baseplate with plastic insert for the opposing (phalangeal) side of the toe joint. The Arthrosurface® total toe is different than other existing replacements because it is implanted into the bone rather than on top, leaving natural bone to support the implant around its edges. This type of implant placement does not disturb any surrounding tissue attachments which are needed to maintain stability and lift-off for walking. The Arthrosurface ToeMotion™ is also the only total toe replacement that is implanted with screws on both sides of the joint to provide rock-solid fixation.

The Arthrosurface® toe systems are indicated for the treatment of patients with the following clinical conditions: hallux rigidus, hallux limitus, hallux valgus and an unstable or painful MTP joint. The implants are designed to match not only the diameter of the damaged area but also the precise radius of both curvatures on the patient’s joint surface. Once the mapping points are defined, the appropriate implant is chosen and then implanted into the patient. Different diameters & curvatures are available to provide a proper fit for each individual patient.

For patients looking to maintain an active lifestyle, receiving a fusion and never being able to move their toe again is not a viable or appealing option. With the Arthrosurface HemiCAP® systems and the ToeMotion™ total toe restoration, patients now have an option that is minimally invasive, completely stable and motion preserving.

How are the Arthrosurface® Systems different than other existing devices?

TotalToevsDF2With the Arthrosurface® Systems, the surgeon only restores the damaged area of the joint, similar to the way a dentist fills in a cavity, leaving the rest of the structures in your joint intact. This way, your native anatomy is preserved. The exposed and painful bone is covered, while all the structures in your joint that help you move and function properly are left in place allowing you to return to your normal active lifestyle.

  • It is custom matched and fit to a patient’s joint size and shape
  • Significantly less cartilage and bone is removed than traditional joint replacements
  • It is placed into the surface rather than on top, leaving the joint less surgically altered
  • Joint motion and the native structures are preserved so no bridges are burned

The HemiCAP® implant was the first implant designed for the metatarsal side of the joint, which is where the arthritic changes begin. This side also tends to have more wear and tear as well as spurring. Other hemiarthroplasty devices replace the phalangeal side, which may still have remaining cartilage and fails to address the primary disease site, which is the metatarsal.


For many patients who have widespread arthritis with damage on both sides of the joint, the Arthrosurface ToeMotion™ system can be a great option. This system restores both sides of the joint by implanting a HemiCAP® on the metatarsal side and a metal baseplate with plastic insert on the opposing side of the joint. Unlike standard total toe replacements or fusions, the ToeMotion™ system can restore a natural range of motion while alleviating or eliminating pain.


What about a Toe Fusion?

Fusion2A fusion is a procedure where the phalangeal bone and the metatarsal bones are cut and shaped to fit together. The two bones are then aligned, set at a predetermined angle and permanently fixed with either screws and/or a plate so the two bones “fuse” together. Once fusion is achieved, the toe can no longer bend, changing the way you walk. Although it provides excellent pain control, a fusion is considered a procedure of last resort because it eliminates all toe movement, making it especially difficult or impossible for women who want to wear high heels. It may also limit activities such as running, golf, tennis and jobs or activities where kneeling or reaching up are required. Over time, it may increase the stresses on the other toes, causing deterioration or damage. It is considered an appropriate treatment for the older, sedentary and less active patient. ToeRangeMotion3Unlike a fusion procedure, the Arthrosurface Toe HemiCAP® and ToeMotion™ system can relieve the pain in your joint and still maintain your natural range of motion. There is also minimal bone removed with the HemiCAP® implant, while fusion plates surgically remove the entire bone surface on both sides of the joint. This means there is far less of the natural bone to work with if future surgery is required. The Arthrosurface® systems leave more bone intact, therefore providing more options should future surgery be required.

Are you a candidate for an Arthrosurface® toe procedure?

  • Aged 35 to 75 years old
  • Want to regain your active lifestyle
  • Want to be able to bend your toe, reach up and kneel again
  • Want to wear normal shoes such as high heels or boots
  • You want to fix your toe problem now versus waiting for your toe to undergo further damage
  • You may have been told by a surgeon that you will need a toe fusion in the future

Surgery and Recovery Expectations

Skiier_IllustrationArthrosurface® technology was designed for patients who want to continue working, have more active lifestyles and have a need for joint preserving treatments. Many of these patients are looking for a treatment option that “bridges the gap” between microfracture and toe fusions. Patients report outstanding pain relief, rapid recovery times and significant range of motion improvements in multi-center studies and the procedure may be performed on outpatient basis. Every surgery has risks and your prospects for a safe and successful surgery must be evaluated with your surgeon.  If you are affected by cartilage damage, a successful joint restoration procedure may significantly improve your quality of life by reducing pain and restoring function. Many patients return to full activity after rehabilitation and go back to doing things that they had given up on in the years before surgery. After the surgical repair of a joint, your doctor and therapist will design a rehabilitation protocol to return strength to your foot so that you can return to your original lifestyle as quickly as possible. Your rehab is crucial to your post-operative motion, so it is very important that you make a strong effort after surgery to follow a protocol that enables you to maintain motion. The more you work on pushing through the post-operative pain to get motion back, the better your motion and outcome will be. Patients are typically encouraged to begin walking the day after surgery without a post-operative shoe. Pain medication should be sufficient so it does not limit your ability to move or your ability to complete your physiotherapy tasks. Formal therapy usually starts within two weeks after surgery to ensure motion is maintained.

Here are a few helpful suggestions as you recover and rehabilitate from your toe surgery:SurgeonPatient

  • Follow the recommendations of your surgeon and physical therapist.
  • Keep a log to track your progress as you recover and increase activity.
  • Ask for assistance from family and friends to help with chores and errands during your recovery.
  • Walking aids such as crutches or a cane may reduce stress on your operated toe
  • Eliminate possible tripping hazards in your home – wires, cables, rugs, etc.
  • Return to any moderate or demanding activities should be guided by your tolerance for weight bearing.

We wish you good luck with your decision and your treatment



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Toe HemiCAP® systems are approved for use in the USA, CE Marked countries and many other markets around the world.

The ToeMotion Total Toe is approved for use in the USA only at this time.