Cartiva - Has anyone had it?

They told me if the ankle nerve block didn't work I couldn't have twilight anesthia and would have to have general anesthia.  But it worked so just twilight anesthia.  I am allergic to codeine so my pain meds were tramadol and tylenol.  But the tylenol didn't work the first 2 days, so I took ibuprophen and tramadol. But on day 4, I was pain free.  Today is day 5.  I went outside and walked a bit for about 15 minutes or so.  Wearing the heel bearing shoe and a flip flop sandel on my other foot that has a higher base (just not 2 inches high base - like the heel bearing shoe)  But my hip is hurting from walking crooked. I came home and laid on the couch and iced for awhile afterwards just in case.  The worst part for me is not being able to leave the house for 2 weeks straight on a beautiful summer day. My doctor didnt say anything about icing after day 3. And he said I was ambulatory. Just no driving until done with heel bearing shoe. I really have no pain.  Just the feeling of stitches pulling that I have had on many surgeries in the past. I can wiggle all my toes.  Even my big toe so I am happy about that.  Sometimes if it is a quick distance, I don't wear the heel shoe, and just walk on the outer edge of my foot, not letting my toe area touch the floor.  The bandaging is so thick, my big toe doesn't move anyways when I walk on the outer edge of my foot. August 1 is bandages changed and I assume stitches out.  I hope this surgery will work. I used to walk 3 miles a day and I am anxious to get back outside and do it again, but pain free this time around.  The pain before the surgery in my right big toe was excruitating!

I'm 66.  I suffered through many years of pain due to large insurance deductible, and finally got medical attention as soon as I got on Medicare last year.  Used to walk 3-4 miles at a time, a few times  week.  Had to stop that about 6 years ago.  Want to do it again. 

Had 2 cheilectomies:  right toe 11/28/16, left toe 5/8/17.  Disappointed with the overall results.  ROM is maybe 50% of what I expected, but great compared to what I had and doctor says it's enough to run.  Arthritic pain is gone, but lots of post-surgical soft tissue pain and some nerve pain.  Relatively pain-free if I don't walk much or do PT--not an option for me.

So I just learned about Cartiva.  I understand it is newly approved in the U.S., but has been used in other countries for decades.  Great info here about recovery from Cartiva surgery, but I'm interested in the L/T benefits.  Does anyone have info, or know where I can go, to learn about the risks, success rates, etc.?

Nancy

Do you live in MN? I do, and I just had the surgery today. All went well, took about 1 hr. I am feeling great and was able to walk with the velcro shoe right away. I will give an update tomorrow. If you would like to know what surgeon I used, let me know. I was the first person he has done this procedure on.  

I was not allowed to drive until the first day of Week 3.  I had to wear a special heel bearing shoe on my right foot until 2 weeks were over. I went for my doc appt on the last day of week 2 and got clearance to take the shoe off and start driving. I wouldn't start driving until 2 weeks are over. It puts a lot of pressure on the big toe to push down the gas pedal and brake pedal and you need to rest your toe for a few weeks to let the implant settle in.  if you can drive with your left foot then you would be ok. But don't get pulled over doing that. BTW it did hurt to drive when I first starting driving.  My toe was aching at the end of my first ride.

Wow! I had no idea a person has to wait that long. I am okay this time around, as I had the left foot done.  My pain medication instructions say I can't drive while on them. That will control when I can get behind the wheel now..But, I need the right foot fixed, as well, so your information is very important. 

No, I live in Southern California.  (MN are my middle and last name initials.)  Good luck with your recovery!

Nancy

Hi Khkorner,

It's not clear to me if you had a cheilectomy or cartiva.  So far, I've only had cheilectomy.  Surgery was about 1 hour.  I slept in the afternoon, (both times).  I was give a velcro shoe afterwards.  As Nancy 0814 said, it's important to stay on top of the pain meds day 2 and 3.  When my right foot was done, I didn't drive for about 10 days, until I got out of that velcro monstrosity.  When my left foot was done I drove as soon as I stopped taking the pain meds, probably day 4.

Nancy

Hi Nancy,

Thanks for asking! I am doing great! I never took any of the prescribed pain meds. Just using ibuprofen once in awhile. More regularly right after the surgery. Had surgery done on Wed, was driving by Friday. Went to my grandson's football game Friday night. Realized I should have brought my crutches with me! Won't make that mistake again.I am very mobile. Will see the doctor a week from today. I only have a velcro, hard sole shoe, no boot. I never even had to ice my foot because there was never much pain in my foot. I am thrilled!

Who was your surgeon? I'm looking at Twin Cities Ortho in Edina.

I was to have surgery with Dr. Coetzee of Twin Cities Ortho but had to cancelled because insurance won't cover the Cartiva implant. Is Dr. Coetzee your surgeon? I've only met hime once, but he is a well respected surgeon for foot and ankle problems.

Dr. Scott Holthusen. He primarily sees patients at the Chaska or Waconia clinics. My surgery was at Ridgeview Hospital Same Day Surgery area. This doctor studied under Dr. Coetzee. I had seen Dr. Coetzee a few years ago, and again in March 2017. When I last saw him, he still only gave me the option of fusion, which I didn't want to do. In April, the Mpls Star Tribune came out with an article about the Cartiva Implant. It had not been approved in MN at that time. In late June, channel 9 interviewed Dr. Silverman in Edina. In July, my daughter had foot surgery with Dr. Holthusen. I had to meet with him after her surgery. I asked if he knew about the Cartiva implant and he said yes, that 2 other patients wanted it, and he was ready to perform the surgery. I went to see him right away, and he put in a request for approval with Medicare, and Blue Cross. It took 2 months to get the surgery approved. Then the facility had to approve it. That took another week. I booked the surgery asap after that. It will be a week tomorrow that I had it and I am doing great.      

Thats great that you pursued your wish for the implant, found a doctor that would do it and got it approved with Medicare and BCBS. I have been denied twice by my insurance, HealthPartners, as the Cartiva being considered 'Investigational' . You would think if Medcare covers it, the insurances would follow. I am gearing up for my next level of appeal. Are you okay with me using your case as one that had the procedure covered by both Medicare and Blue Cross?

-Jan

that you are doing well!

Yes, you can use my example to help get yours approved. I sell Medicare health policies, so it was important to me, too, to be able to let my clients know that this procedure was approved. I couldn't figure out why it was taking so long to get approved in MN. There is a Youtube video of a lady who had it done in October 2016 in Florida. 

Here is some information I sent to someone else and will save you the time of looking for it here.

Dr. Scott Holthusen. He primarily sees patients at the Chaska or Waconia clinics. My surgery was at Ridgeview Hospital Same Day Surgery area. This doctor studied under Dr. Coetzee. I had seen Dr. Coetzee a few years ago, and again in March 2017. When I last saw him, he still only gave me the option of fusion, which I didn't want to do. In April, the Mpls Star Tribune came out with an article about the Cartiva Implant. It had not been approved in MN at that time. In late June, channel 9 interviewed Dr. Silverman in Edina. In July, my daughter had foot surgery with Dr. Holthusen. I had to meet with him after her surgery. I asked if he knew about the Cartiva implant and he said yes, that 2 other patients wanted it, and he was ready to perform the surgery. I went to see him right away, and he put in a request for approval with Medicare, and Blue Cross. It took 2 months to get the surgery approved. Then the facility had to approve it. That took another week. I booked the surgery asap after that. It will be a week tomorrow that I had it and I am doing great.     

I found out that some facilities are not approving this procedure because the implant itself costs about $5000 and the hospital or surgical center ends up absorbing a lot of that cost. I have not seen all the bills come through my insurance yet. I just made sure to get pre approval from all involved, before it was done.

wonderful news! had my surgery Oct 4th. Hope mine goes as well. I can't believe how much movement you already have.  Was it moving before the surgery? Had you started bending it before stitches came out?

My toe was 100% not bending for at least 10 yrs. A  couple of days after surgery, I thought I would see if I could wiggle the toe and it moved.  So I just wiggle it up and down every once in awhile, nothing aggressive. My own form of PT. Some people have written that it is hard to move after being stationary. But then again, some people are in a boot for 4 to 7 weeks, where they can't move it. I don't understand that, unless there was another procedure done, too. 

My toe had limited movement before surgery. At day 5 I am wiggling it around as I am afraid of scar tissue building. My toes are very bruised. I am walking in a post op wedge sandal, a few times I maybe just walked on my heel, to bathroom not good but looking forward to getting ace bandage and dressing off in 2 weeks and really starting to bend the toe. It is so heavily wrapped in dressing that I can't fully bend it but am able to wiggle all my toes sticking out of dressing and have actually stood on it trying to move it up and down with support from other leg.  I am just desperate not to have scar tissue build up, I know I have to balance healing with this. Your outcome has been amazing, particularly if you had no movement going in. I had maybe 20% and bone on bone. Almost zero upward. I can see it moving upward ever so slightly, I guess I will have to retrain it.

Yes from what I have read this is correct.  My doc did not tell

Me he was doing the osteotomy until I was going into OR. I did not plan on this "extra" recovery. I am relatively young and active person.  

Hi Jan,

So frustrating when we read that that it has been done for a year in other parts of the U.S. One gal on the Facebook Cartiva Implant page, says her doctor had done 40 other people before hers. It took 2 months for mine to get Medicare and BCBS to approve it. Then the facility, where it was done, took another week. I was told today, the facility just okayed doing a few Cartiva implants. Thankfully, my surgeon asked right away for me to have both feet approved, so I am going forward. Planning on the other foot Nov 7. If you are on Medicare, you could change to Blue Cross for 2018 and put in for a pre approval asap in January. I sell Medicare health policies. If you don't have your PDP attached to your 2017 medical policy, you could change to a Blue Cross Cost plan for an effective date of Nov 1. If the PDP is attached to your policy, you can't change in 2017. Hope this helps!