Comparison of treatment options for your painful toe

October 25, 2013

toe fusionA recent article in the Podiatry Today journal highlights the Arthrosuface Toe DF HemiCAP as an emerging surgical advancement for the treatment of Hallux Rigidus. Hallux Rigidus can be defined as degenerative arthritis and stiffness in the first MTP (big toe) joint due to bone spurs. The article discusses the HemiCAP and compares it to various other treatments such as total joint replacements and arthrodesis using the AOFAS scoring system. The AOFAS scoring system is a standarized outcome measurement tool used by surgeons to evaluate the outcomes of various treatments in the forefoot. With this scoring system, the Toe DF HemiCAP achieved the highest mean score for the treatment of Hallux Rigidus with many advantages over fusions & total joint replacements. Below is an excerpt from the article:

“Metallic resurfacing of the metatarsal side of the metatarsophalangeal joint has shown promising results as an alternative to arthrodesis. Arthrodesis can result in difficulty squatting or kneeling, running and wearing shoes with a high heel. The patient population developing hallux rigidus appears to be younger than previously reported. This is likely due to increased activity and the type of sports that they are playing. These patients are often resistant to the idea of an arthrodesis and are looking for alternatives to maintain joint motion.”

“Kline and Hasselman reviewed 26 patients (30 implants) with stage II or III hallux rigidus who had metatarsal head resurfacing with the HemiCAP® implant.45 At 27 months post-op, the researchers noted improvements in mean active range of motion (from 10.7 to 47.9 degrees), mean passive range of motion (from 28 to 66.3 degrees) and mean AOFAS scores (from 51.5 to 94.1). The average time for returning to work was seven days according to the study. All patients reported excellent satisfaction at 60 months and the study authors also noted an 87 percent implant survivorship at this time.”

>> Read the full paper published by Dr. Brent Haverstock

For Patients: What is the difference between a Fusion and a HemiCAP?

toe implantA 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 foot/ ankle 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.

toe joint painUnlike a fusion procedure, the Arthrosurface Toe HemiCAP® will 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 existing joint replacements and 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 HemiCAP® system leaves more bone intact, therefore providing more options should future surgery be required.



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2 responses to “Comparison of treatment options for your painful toe”

  1. Sana Bridges says:

    Hello, My name is Sana. I am a 60-year-old athletic female with a severe Hallux Rigidus. I saw several surgeons. Some recommended the Cartiva implant saying that the Hemicap doesn’t work and others said the opposite. I am concerned about the effectiveness and longevity of both implants and since I had opposing opinions, I am not sure what to do. I am unable to hike or do my regular gym workouts because of the pain and quite honestly, I don’t trust any of the surgeons I’ve seen. What do you think about the Cartiva as opposed to the HemiCap and vice-versa? Thank you


    • arthrosurface says:

      Hi Sana, We sent you an email a few weeks ago with additional information. Please let us know if you did not receive it.

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