Cartiva - Has anyone had it?

Hi Tracey! 

I had this done in Philadelphia March 1. It is not as easy of a recovery that I thought. I am in a post operative shoe still. I have throbbing constantly. I am almost 3 weeks. I was in bed for a good 13 days ice and elevation before I came downstairs for dinner. Now I get around the house fine in the shoe but I lay down with my foot up every hour. I am not driving yet. I have no swelling and very little bruising but still throbbing pain. I lived in constant pain from arthritis and it was so bad all the time that I did not want to go to social events just thinking about the pain. Like you, I was limited in my footwear. So this is way better than fusion but not the easy recovery I thought. I would tell you to do it before you are not a candidate anymore. Let me know how you make out!

Rosalyn

Wow...Rosalyn....hope you are doing better than this post now...i know i replied to you on another one also, but my doctor wanted me up and weight bearing asap, as soon as the nerve block wore off.  so that's what i've been doing. And he didn't say to put ice on it, just elevate toes above nose for several days. 

Hi Tracey,

I had my surgery 10 days ago. I had a failed Cheilectomy dec-2015, so for this surgery I spent a lot of time researching to find what I believed to be the right doctor. I've seen over 10 Ortho Surgeons for this and the one I went to looked not only at my MTP arthritis but my whole foot mechanics. His opinion was that I needed to have my metatarsal on the big toe joint shorted as well in order to have a very sucessful Cartiva. He also had to fix what was done wrong in the first surgery, so......kind of a mess. He has done over 50 cartiva surgeries and is a foot&ankle specialist. I did a year of research before deciding. So my recovery will be based on the mid-foot fusion more than the cartiva, which is much longer.

I am hopeful that the Cartiva is right for me. I have the recent publish results of the Cartiva study done in the US.

My only other option was an MTP fusion and I'm too active to want to go that route at this time. The mid-foot fusion is on the next joint up which doesn't move that much anyway. When moving/walking, most of the pressure and flexsion is in the MTP joint.

After the first surgery I had more pain and very little ROM.

The doctor said that it went well, and is optimistic about the outcome. I get the stiches out in about a week when I'll start wearing the boot for 10-12 weeks.

Sorry I won't be much help regarding the Cartiva specifically right now, but hopefully can provide more info in a few months when I can begin to use it.

Only thing I can stress, is do your research! Find the right solution for you then find a skilled surgeon with lots of experience doing it.

 

Thank you Rosalyn and Tracey,  I had Cordiva big toe joint replacement surgery five days ago and thought my recovery misery was unique.  Crutches did not work welfor me, but a cane has been much more useful, but slow.  The toe throbs constantly. Keeping it elevated on a pad coverd with pillows helps. 

Do Others know how long one can expect total recovery to take??

Doug

Krista,

I have been doing a ton of research and have put off doing anything about my painful toe for years beacuse I wasn't willing to  do the fustion surgury and the other options just didn't seem like good ones. I was excited to hear about Cartiva. I have been reading alot about it. I have a consult appointment with an orthopedic surgeon at Yale in Ct this coming week. He was the only one I could find that has done this surgery before. I'm hoping if all goes well I will have the surgury summer or fall. I'm hoping I'm a good candidate. I will let you know how it goes. Good Luck to you I hope your recovery goes well. 

I am 9 and a half weeks and doing much better. I get around all day in an athletic sneaker. Mild swelling in late afternoon, at which time i take off the sneaker, massgae a little and relax and it feels better. I have good range of motion in the toe. I am not better yet. It is a slow recovery. I think a marked improvement happens at 3 months. How are you healing?

That's great Rosalyn! Glad to hear this worked for you!

Could I ask a few questions?

How much improvment in RoM did you get?

Did you get physio to do? When did you start?

Did you find the toe stiff after the surgery? If so, when did this start to noticably improve?  While I had more than just the Cartiva, I did have the Cartiva and find my toe quite stiff - it's been 3 weeks since the surgery. I was in a case for the first 17 days and only started the physio for the toe 4 days ago.

Thanks!

Hi Krista. I have a big improvement in ROM since my surgery. My doc had me start moving my toe up at the joint around 2 weeks after surgery. I remember it hurting a lot and having a pulling feeling. At 5 weeks I started down also which is at full ROM already. I can lift it up more than halfway almost straight up. I am thrilled with range of motion. I had to work at it constantly from the 2 week mark and it kept getting better and better. Although if I lift up my heels to stand on my toes AND weightbear I cant do it because it hurts under the toe, almost a weak feeling. But I can lft up my heel and not put weight on it completely fine. Maybe like a 4" heel height. I know I'm not better yet because it still hurts and feels sore and I get swelling after being on it in a sneaker. I don't get swelling in a Birkenstock or a hard soled flip flop. My doc said no physical therapy other than moving the joint up and down. I have gone to physio because my friend is a physical therapist. I don't think it can hurt. I have gone maybe 10 times since the 5 week mark. I am not going to go anymore and listen to my doc and give it time.

My toe was mildly stiff after surgery but it loosened up when I started wearing a sneaker. The birkenstock babies the foot and limits movement in the toe so I started wearing a sneaker more to get the toe moving. I started wearing the sneaker at 3 weeks. 

I am 10 weeks tomorrow. Sometimes I feel a slight throbbing or sore feeling. I have a pulling under the toe when I walk in a sneaker. I am fine walking barefoot which my doc said I can do. 

I developed arthritis from a failed osteotomy done 6 years ago and it was bone on bone. This surgery saved my mobility and I am excited to continue to improve.I dont have the arthritis pain anymore which is a miracle to me.  It is a hard and slow recovery. Not as easy as i thought it would be. Please let me know how you are doing. 

Hello Rosalyn,

I am 10 days post op having Cartiva implanted in both feet with Phalangeal Osteotomys.  I was immediate weight bearing walking from outpatient procedure.  I was very disciplined ice 30 minutes and walking 5 minutes for first 5 days. No pain medications taken until day 3 post op when the first block apparenty wore off and experienced intermittent painful sharp nerve throbbing.  Started Tramadol 50mg but very little relief until instructed to boost with Acetaminophen.  Post op day 5 bandages were changed and physician asked if I was experiencing any pain.  He seemed surprised when I described the sharp throbbing.  I was instructed to walk 15 on/15 off, but no range of motion excercises yet.  Day 12 follow-up stitch ends will be cut-apparently with the plastic surgery stitch technique utilized the sutures will not be removed.  I will continue in the shoes for one week following. My question to you and anyone else...Did you experience the sharp pain throbbing or is this an unusual response? If so, how long until it subsided?  Thank-you in advance. Robin

yes, definite throbbing pain. How did you walk away from the surgery if you had a block?  with a block your leg is completely numb, like it's not even attached. i had no control over that foot/leg....had to use crutches till 1.5 days later when it wore off. 

Hi Rosalyn, can I ask, what makes one a good candidate, and what precludes one from the surgery? Thanks

Kathy,

The anesthesiologist explained that my feet would have a local block. He also said that I  would receive anthesia  just short of general due to having both feet done at once.  I did walk out of recovery under my own power without crutches, so it may have been specifically local to MTP and great toe, as my leg, calf, and foot were functional.  I had my 12 day post op follow-up today and physician did not seem to be concerned with intermittent nerve pain, so I assuming it is normal at this point.

Opps sorry Kathie! Not Kathy.

I have it equally bad on both feet and I'm seriously considering getting both done at the same time 

I think your about the first person I've heard from that's actually did  both at once  pretty much everyone else is saying they wouldn't recommend it

some  saying most doctors wouldn't even do both feet at the same time ?

How are you getting around are you able to walk shower drive ?

I called Cartiva got a list of doctors in my area then ran it through my insurance see which doctors where on my plan and today i made appointments with 3 differnt doctors with in the nexrt 10days

Hello Markee

I am sorry I just saw this, I responded earlier to your previous posting.   

I can not get foot wet until tomorrow day 13.  Rinse foot in shower, blot dry, spray with Bactine cover each with two band aids where he cut internal sutures today.

You will definitely have to figure out if you have a set up that will be safe for bathing/showering.  We have an extra shower in the basement laundry/utility area.  I showered sitting on a two step plastic stool backed into shower with feet on floor outside of shower.  The dressing covered in plastic bags but under shoe to stay steady on feet.  I used the detachable hand held shower hose and showered normally.  Just put plastic bags on feet when you are already sitting and ready for shower and take them off as soon as you are finished.  Don't walk away from shower with them on as I am sure they could be slippery.  Not sure doctor would condone the above, but it worked for me.

No driving for sure, until boot is off.  I may or may not have driven for emergency Mountain Dew on day 10, but I would not recommend it.

I also did the same.  I called about 15 physicians from the Cartiva list and usually was given the surgical nurse to speak to.  I spoke to all but one who did not call me back.  My most important question was how many Cartiva's they had done.  I had one surgical nurse that told me that she had been with the physician for three years and he had done a couple hundred in that time.  I clarified Cartiva implant for MTP and she said yes.  I didn't figure that there was any need to debate that fact with her.  

The physician that I chose had completed 20 Cartivas and is a DPM.  I had consult with him on 6/12/17 to determine if I was candidate for Cartiva in my right foot.  I inquired about a cheilectomy for my left foot and he said that the most appropriate solution would be a Cartiva in my left foot also.  My surgery was performed 6/14/17.  When I initially spoke to the surgical nurse she blocked that surgical slot contingent on whether I was a candidate.  

I would also check the price for your surgery.  I called the hospital, anethesiologist, and doctor the day before for 5 digit billing codes and their prices.  I confirmed that each were participating with my insurance, the procedure had been approved by my insurance, and what my expected liability would be.  My portion of the outpatient hospital is $1089.81, the hospital billed $38029.83, the insurance had negotiated a rate of $5217.61....luckily for me.  I knew what my portion of the bill was, but I was still shocked with the amount the hospital billed the insurance for the outpatient procedure.

I did the best I could vetting the doctors, but you never can be 100% sure.  I took a leap of faith and hope for the best of outcomes.  

I am taking the summer off work, so I thought it would be a great time to get my feet taken care of......and I just couldn't stand the pain any longer.  As far as you returning to work....if I had a desk job and could elevate my feet, I feel like I could have gone back to work today if I had to.

I wouldn't think twice about getting both of my feet done at the same time again.....however it just depends on your circumstances.

Hopes this helps and good luck with your consultations.

Thanks for that long reply 

I'm already setup with 3 Orthopaedic Surgeons the rest of them on the Cartiva list are DPMs so I"m working my way down the list starting with the Orthopaedic's sugeons also waiting for some call backs also from the doctors surgical nurses. 

As far as insurance goes I'm on the aca I have great insurance zero deductable and like a $1200 yealy max limit so no worries there as long as i get it done before the end of the year with all this mess that going on right now trying to repeal it its forcing my hand to get this done now while I'm still covered I'm afraid I won't have any coverage next year just hope i can get this all done before the end of the year

How can I access the provider list?

I live in central coast Calif.

Thanks John

I couldn't find a list on there site

I had to call cartiva (877) 336-4616 and they emailed me a list of local providers 

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I contacted Cartiva directly through their website and asked for a list of surgeons trained in the Cartiva procedure in my area.  I gave them a pretty broad geographic region.  I then called each one to see how many Cartiva procedures they had performed, I often spoke to the surgical nurses regarding the procedure and their outcome.  I had to travel 2 1/2 hours one way, but hoping it will be worth it in the end.

Where did you go to have your surgery?  Sounds like you did your research!

 

Am I understanding that you had both feet done at same time?  How are you doing 2 months out?  I'm considering doing both, or one at a time.

 

I did my right foot only. But..... I am 3 weeks out. No pain.  It only hurt on day 2 and day 3 then I was fine. A friend of mine did both feet at the same time and it only hurt for him on day 2 and day 3 also.  You would be totally fine doing both feet at the same time. I am 3 and a half weeks out from surgery and I am already walking 2 miles a day.

Sorry Carol I do not see the reply I thought I posted earlier so I will try to post again.  Yes I had both feet done at the same time, knowing what I know now I wouldn't even consider doing them separately.  The only pain I experienced was early day three when block apparently wore off and I had not been taking any pain medication and intermittent nerve pain.  The surgical nurse said that the nerve pain was due to the nerves growing back after the trauma.  The nerve pain subsided by about week four.  Last week I began wearing my own running shoe, the previous three weeks I wore a pair of my sisters that were 1/2 size larger than mine.  This week the physician advised to wear wedged heel shoe to assist increasing the flexion/extension of toes.  I had taken the summer off work, but will go back in September and put the toes to the test.  I had my surgery on a Wednesday and if I had a desk job where I could have elevated my feet, I would have felt comfortable returning to working the following Monday.  

Hi Carol16263,

I had it done in Canada. And yes, research into every aspect is crucial.

Let me know if you want more info.

Do you have Hallux Rigidus as well?

I had my surgery two weeks ago at Duke in North Carolina since no one in my state had any experience with Cartiva.  Pain has been very manageable.  Just had my stitches out today.  My local doc thinks I should be working range of motion, but my surgeon says to wait until I start PT at the one month mark, so I will follow that advice.  I'm hopeful on that front, but trying to keep my expectations realistic.  Anything will be better than what I was dealing with, and I definitely wanted to avoid fusion.

Hi Suzanne

Did you have cartiva only? Or any other procedures? 

Hi Abbe,

I had a cheilectomy, the cartiva implant, and correction for a bunion.  I was in a good deal of pain prior to the surgery, so I'm very hopeful on this end of it!

Suzanne

Thank you all for your reports.  After 1.5 of consulting with Surgeon that offered fusion I finally found a surgeon that offered the Cartiva solution.  After 3 more month of hesitation I will have it done, Left Foot next week.  Reading all your remarks help a lot.

I will also have the top bone shaved.  Did anybody have that done too?

I do hope for a speedy and Little pain recovery.  Had enough of suffering constant pain for such a long time.  

how is your foot now. would you do cartiva again? I just had it done, I had failed cheilectomy and was bone on bone. I had very little ROM before the cartiva. dr said he got good ROM during the surgery, cleaned out lots of arthritis and scar tissue. he says I have to get toe moving to prevent scar tissue build up.

 

OH my goodness - I don't know if you have any more updates on here, but I just discovered this forum so I'm reading all of these just now.  I am about 3 1/2 weeks out from my cartiva implant and still suffering a lot of stiffness and pain from the stiffness.  I am still in a walking boot and no PT.  Still swollen too.  On a good note, the scar on the outside of my foot is looking much better!!

Anyway, I read that you too had bone on bone from your arthritis.  I too had bone on bone....they chiseled a good chunk off the side of my joint along with the implant....as well as some bone spurs.  I was just getting discouraged with how stiff my toe still is.  And along with that pain when I try to move it or walk on it normally.  After reading your post, maybe I'm just not being patient enough.  It is discouraging to not have mobility back just yet.  I'm hoping that eventually I can wear real shoes again without any more pain.  But the ultimate goal is to be able to exercise again - maybe even light running and to have that mobility back that I haven't had for years.

I had this done on my left toe about 3 1/2 weeks ago and will have my right toe done this summer.....if I ever recover from this surgery.  I had bone spurs as well and shaved off arthritis on the side of my right metatarsal......still in a boot and my toe is very stiff and pretty sore any time I try to walk normally.......my goal was to get mobility back and no pain.  I think I am just not patient enough - seems like this is a long recovery.  Longer than what I realized.  But if I can exercise again and do it without pain, it will be worth it.  It stinks for right now though!!!  I hope you do have a speedy recovery - will be curious to hear!

Hi Tracey - I'm in CT and looking for an orthopedic doctor to do this surgery.  How did things go at your Yale appointment?   I realize this was almost a year ago that you posted.  If anyone else has a recommendation for a doctor in the New Haven area I'd love to know about it. Thank you!

Hi Terry, I too have bone on bone with bone spurs. I'm facing this same surgery. Did a orthopedic surgeon or a podiatrist do your surgery? If you don't mind me asking your age, as I am 64. Thanks for your help.

Hi Linda!!

Yes, i had an orthopedic surgeon doing the surgery.  It's been close to 3 months and I have had quite a lot of improvement.  I am still wearing tennis shoes to work as anything else is just too restricting - unless it is a nice square or round toe shoe,  The toe is still rather stiff - and a little sore, but it is so much better than it used to be.  I probably do not do my stretches like I should.  The Dr. did NOT prescribe any PT - just showed me some stretches to do at home.  I have to say that the pain I was having before is not the same sort of pain I am having now.  Any pain that I have now is strictly from the surgery and the stiffness that remains.  He told me that most foot surgery takes at least 9 months and up to a year to recover and not have any pain/twinges.  I think the only thing I am a bit discouraged about is that I do not have much ROM back.......maybe less than I did before.  HOWEVER, the pain is what is the most improvement and I think If I really concentrate on stretching and moving and curling my toe, I will get more ROM.  I am 50 years old and WAS fairly active.  I am hoping to get back into running again - but it was not advised as they don't know how long these implants last.  But I will probaby still try. HA

Good luck if you end up having surgery.  It isn't terrible at all - you just have to be patient as it is a bit of a long recovery.  I was up walking around the next day with a boot on, but I wouldn't recommend doing much for the first week or so as the swelling is what is the worst thing after surgery!

Hi Linda,

I had surgery on December 6th I'm about 9 weeks post op. It went well. The orthopedic surgeon was Dr Reach he was wonderful. I still have a little soreness and stiff I keep working it and it is improving I do still have some swelling at night I put ice on it and put it up. I have al to better range of motion than before surgery. Please let me know if you have any specific questions I would be happy to answer them. 

Hi Tracey,

Thanks for your post! I have an appt. with my orthopedic surgeon on Mar. 2 and will know more. What was your pain level after surgery?

Hi Linda,

I didn't  think the pain was bad at all. I had a block and took pain meds on schedule for the first  2 days, I wasn't in pain. On day 3 I switched to Tylenol or Advil and I was fine. I stayed out of work for 3 weeks. I had stitches out week 2. With the swelling I couldn't get a shoe on I bought a wide shoe to wear. I kept it elevated. When I went back to work week 3 I was able to get my sneakers on. I'm still wearing my sneakers for comfort. I think the biggest take away is work your toe it will be stiff and sore and you will want to walk on the outside of your foot. I still have to think when I walk and make sure I walk correctly it is still sore when I walk but it is improving. 

Where are going to have it done? when I had schedule mine Yale was the only place I could find a doctor that had experience in Cartiva. 

Hope this helps good luck. 

Hi Tracey,

I live in Anderson SC. We have several pods but only one orthopedic surgeon that does this surgery. Will find out more on March 2. Will let you know.

Thanks for all your comments!

Hi Krista who was your surgeon and where does he practice.

The challenge is finding a Dr who has done Cartiva over and over again.

Nancy

Hi Linda, I live in Fairfield CT and just had Dr Lazeroff in Newtown,CT performa Cartiva implant on me 4 days ago. I am off my pain meds and elevating and icing, very little pain at all. Kind of hard to believe how low the pain is.

Philosophically joints muscle and tissue don’t benefit from being immobile, I can’t believe how many patients report doctors telling them to stay immobile. My doc says walk as you want then elevate and ice from day one. One of the reasons I picked Dr Lazeroff. 

I am a 46 yr old male, with bilateral stage 2-3 hallux rigidus presenting with severe pain. Highly active, ski, golf, golf, bike etc, work out and diet lifestyle highly important to me. I have had 2 shoulder repairs and an acl reconstruction, surgical, rehab and pain med experienced.

 

Hello TraceyCT...I just had my Cartiva surgery 11 days ago by Dr John Reach at Yale New Haven in CT. Not sure if this is who you consulted but I am very pleased so far. I had stitches removed today and am doing PT on my own until I begin with a local physical therapist next week. I have spent the last 11 days sitting or laying as much as possible with foot elevated, taking pain medication as prescribed and wearing my foot boot. I have little pain, in fact only when I "overdo it". I highly recommend Dr Reach and this procedure if you are like me and have had pain when walking and have not been able to bend your big toe!

Hi Tracey and runnerlori,

I am in Fairfield CT and had both done - One April 20th the other June 15th. By Dr Stephen Lazeroff in Newtown CT.

I am just now fully returning to my life pre toe drama. Today I ran on the treadmill, and lifted, am walking normal ish, occasional advil, 2x a week or so. No pain at rest, ice and hot baths are huge. Range of Motion is really very very good on the one, still getting there on the latter half, but so far so good.

Some people have a quick recovery, my diet and weight were not good and too high, so i have lost weight, starting exercising, and the world is so much a better place!

I think a healthy fit person would be close to normal in 4-5 months, for me, I am in the 6-8 month range for all pain and range of motion to return to a good level.

It seems like all the stories vary quit a bit. I'm 9 months out, I have some pain but it's manageable and not too worrisome. It seems to be getting better at a rate so small I don't notice it. That said, I'm 64, in good health, weigh about 180 and I play pretty singles tennis 3 to 4 times a week and am also undergoing intensive athletic training. Neither of these activities bother me at all. But I do have pain when walking. And I have no pain at all when sitting.

My recovery was very different than anything I see on this forum. I was in tennis shoes and driving after 2 days. I was back at work after 5 days. Playing tennis at 4 weeks. All this with Dr. approval.

I am 9 months out..5'5 150 pounds.. I am just now starting to feel little to no discomfort when I walk.. it's been a long road and much more difficult than I expected & was originally told it would be. I am a hairstylist by profession .& I also exercise at least 3 times a week..all of my work/ personal time was really impacted by this surgery... still need time to continue to heal before I can honestly say that I am glad that I had this done

Thank you for your reply. I hope to make progress each day. I still have steri strips intact so trying not to push it. The "in limbo" phase is a little depressing so I think its important to get back to working and doing things that you enjoy that don't involve strenuous physical exertion. Good luck in your journey!

I would agree very highly with this statement, it is improving at a rate so small i barely notice it.

It seems as time goes by the pain remaining is slowly dripping away, there was never the aha moment, except that at rest I dont have any pain at all, and shoes fit fine now with no issue.

All of my remaining pain is in the ball of my foot, and my one foot on the outside of the foot as I have rolled a lot avoiding the ball pain, all slowly subsiding at month 6 out.

I have not been able to play tennis or run as the others have. But now I would say that I am able to do that, as I am running limited amounts on the treadmill today with no substantial pain after.

I am not a runner BTW, just doing it to train my body back into being fit.