HemiCap Toe Implants

The 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.

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

Product Features


  • Screw based implants provide rock solid fixation
  • HemiCAP DF® dual implant curvatures improve dorsal role-off and prevent osteophyte regrowth
  • ToeMotion™ screw-in baseplate and modular poly inserts provides optimal intraoperative flexibility
  • Super smooth articulating cobalt chrome surface to minimize wear on the opposing side
  • Conical shaped screw to optimize bone-screw interface
  • Inlay arthroplasty and minimal bone removal allows for future fusion if necessary – “No Bridges Burned”
  • Anatomic inlay of Toe Classic HemiCAP® maintains the length of the lesser metatarsals
  • Standardized thread pitch for precise depth and decompression
  • Proven clinical history with over 20,000 MTP implants

Surgical Technique

Toe_STThe Toe HemiCAP® implant system is comprised of two parts, an articular cap and a fixation component. The instruments are organized in the order of surgery, proceeding from left to right and top to bottom. The procedure begins with a guide to identify the size of the metatarsal head. Then place the guide wire perpendicular to the head. A step drill is used to prepare the screw hole before the fixation component is advanced (joint decompression can be adjusted by advancing the screw 2-4mm). The uniquely designed instruments are used to map the contours of the patient’s native surface curvatures using the fixation component as a central axis.  A reamer then removes the damaged cartilage to create a socket for the implant. If using the DF HemiCAP®, a second reamer is inserted into the screw to ream the dorsal socket. Place the trial to assess proper implant fit. After, any osteophytes or boney edges are trimmed off around the implant so bone and cartilage surfaces surrounding the implant are flush. (If you are using the ToeMotino Total Toe System, skip impacting the DF implant and contiune on to the next paragraph). If you are only implanting the DF HemiCAP®, once the surface preparation is complete, the implant is positioned and seated with several taps of the mallet.

The ToeMotion™ phalangeal component is prepared in a similar manner. A guidewire is placed perpendicular to the phalangeal surface. A reamer is then used to prepare a socket until the reamer is slightly recessed to the surrounding surface. The sutures of the sterile delivery tool are then placed behind the phalangeal component and this metal baseplate is then screwed into place so that the final implant is slightly recessed. Plastic trials are then placed into the baseplate and a range of motion is performed to assess which insert is best for the patient. Once the proper insert is chosen it is placed into baseplate, the delivery tool is then cinched down against the implant and the lead sutures are then twisted until an audible click is heard which means the poly has locked into the baseplate. The DF HemiCAP® is then impacted onto the metatarsal taper post to lock the morse taper. The wound is then closed.

Advantages for the Patient

SurgeonPatientHemiCAP® technology was designed so patients can continue working and retain an active lifestyle without compromising future treatments.

  • May be performed on an outpatient basis
  • Allows for preservation of bone and soft tissues
  • Bridges the gap between biological therapies and joint fusion
  • Clinical studies demonstrate positive clinical outcomes at 5-7 years
  • Maintains existing joint biomechanics thereby allowing normal motion
  • Patients experience a rapid return to activity for both work and exercise
  • Patients report pain relief, rapid recovery and  range of motion improvements

Advantages for the Surgeon


  • The HemiCAP® procedure is intuitive and easy to learn
  • The minimally invasive outpatient procedure typically takes less than an hour
  • Soft-tissue envelope and native joint biomechanics are maintained
  • Skeletal anatomy and bone stock are preserved allowing future fusion or total toe
  • Phalangeal surface reamer allows for a controlled chielectomy
  • The two components are connected together via morse taper, with zero reported loosening

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.

NEWs / updates / blog

  • Quick Facts

    • Little to no activity restrictions making the implants an active alternative to joint replacement.
    • The HemiCAP™ Implants are custom matched and fit to a patient’s joint size and shape.
    • Significantly less cartilage and bone is removed than traditional total joint replacements.
    • It is placed into the surface rather than on top, leaving the joint less surgically altered.
    • No reported Loosening.
    • Allows patients to Stay Active.
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