Cartiva - Has anyone had it?

Had my surgery 2 weeks ago.  Today I went in and had the compression bandage removed and I am done with the heel bearing shoe.  I was given a very interesting sling for my big toe.  It basically keeps my big toe lifted so when I walk my big toe is not hitting the ground.  Then I was given a regular low heeled surgical shoe with velcro straps. I am allowed to swim, walk, do whatever I like now at week 2.  The only pain I am having is nerve firings. Otherwise I don't feel any pain in my toe like I had pre surgery. I did spend a good portion of the first 2 weeks laying on the couch with my foot elevated and ice on the bandages. So far I am happy.  I will be even happier when I return at week 5 and I am done with the surgurical shoe completely.  I did suffer from terrible arthritis in my right big toe and I have a very high ANA positive reading. I do have bad arthritis in my hands, especially my right hand, and I have had my right middle finger fused due to arthritis.  Wish they had an implant ready for fingers but fusing was my only option at the time. I asked my doctor about cortisone shots post op and he said he has never had a patient that required cortisone injections post op cartiva implant. So I guess time will tell how I do as the weeks and months go by.

Hi Nancy, thanks for your post. Glad to hear you're happy with the result. May I ask what grade your hallux rigidus was at and how old you are? Many thanks.

Hi Nick, I am 62.  I had grade 3-4 hallux rigidus.  And my implant size was 10 mm.  With the post op shoe my doctor has me wearing a bioskin wrap around my mid foot and a wrap around my toe too. I am supposed to exercise 10 x up and 10 x down three times a day.  It sure is stiff. I walked a mile today so far. They told me I could walk three miles if I want but split it up over three times a day. The surgery was quick. Only 1/2 hour total. 

Do you have rheumatoid arthritis? Just asking as I was under impression that cartiva is not recommended in this case. At least that is what my surgeon said. Is your toe bending at all?

 

I do not have rheumatoid arthritis I just have regular arthritis  in my big toe. Plus all the cartilage between the toe joint has worn away from wear and tear.  The cartiva implant replaces the cartilage that has disappeared in my toe joint. Yes I have movement in my toe.  But before the surgery I basically had no movement in my toe joint. So I am pleased with any movement I get following this surgery.  Arthritis is what wears away the cartilage so not sure how your doctor could tell you that.

 

Karen80368 - Not sure if you were talking specifically to me(I'm the one with zero improvement since my surgery in Nov 2016.  My left big toe was stage 3, and had also had a failed cheilectomy 2 yrs prior).  Per my blood work, I am negative(at this point) for Rheumatoid arthritis.

In the meantime, I'm seeking out a second opinion from a prominent sports medicine orthopedist in Kansas City.  I'm not willing to give in to a fusion yet!

Laurie by zer improvement do you mean in range of motion or do you mean in pain, if the pain goes away I will be happy with not a lot of movt as I didn't have much movt before anyways, 

Hi Nancy - Zero improvement as in still in pain with every step.  There is a bit more motion - but with the same amount of pain as prior - I don't care that it bends more.

I know a cortisone shot will help - but I do not think I should still have to have shots after the cartiva.  With all of these success stories, I'm very concerned that I have had a botched surgery!  I will keep you all informed if the new doctor has any additional insight.

OH - and one more piece of info - my dr is fully aware that the surgery wasn't successful.  He blames it on the fact that I had a Cheilectomy prior - and when people have had a prior surgery on the joint, it doesn't work as well as it does for those that have not had prior surgeries.  His solution is a fusion.  Nothing else.  I'm highly disappointed, as you can tell!

My doctor said the same to me. He wouldn't remove my bone spurs or shorten the bone to remove arthritis. I had no prior surgeries on the toe. I am five weeks out. Not much movement. Still have pain but not as bad as before. My doctor said yesterday this is no magic bullet. It works for some but not for everyone. Only time will tell if I have success with it. He said wait five months. 

Just wanted to follow up with the group - since I seem to be the minority when it comes to Cartiva!  I'm the one that had it Nov of 2016 with better ROM but still major pain(47 yrs old).  I am ANA positive, confirmed osteoarthritis in several joints, negative thus far for rheumatoid arthritis, and have not tested positive for Lupus with any of the conventional tests.  The surgeon who did my surgery had told me a fusion was the only way to stop the pain.  So I went for a 2nd opinion with the surgeon who works with the Kansas City Chiefs and the KC soccer team.  1)He confirmed that the cartiva surgery would have been his recommendation for me, 2) the xrays look good - and he cannot see any thing on the xray that would indicate a reason for the pain, 3) with my history - he also is recommending a joint fusion.  He confirmed inflammation in the joint itself, as well as inflammation in the outer sesmoid directly under the joint.  The only other option for me (other than fusion) is to wear a shoe insert with a hole cut out under the joint, and a turf toe plate underneath it.  So I think it's safe to say I'm very much the exception to the rule when it comes to cartiva implant surgery!

Laur sorry to hear about your results as I am also ANA positive with a pretty high score and suffer with arthritis pain everyday. So far cartiva seems to be helping me. I do wear mortons extensions in my shoes when I go for my long walks outside. This does limit my range of motion and I don't feel any pain. I am only 9 weeks so far. I did lupus testing too. A friend of mine did a fusion a few weeks ago and is having a very easy recovery surprisingly. 

Just wanted to say I'm sorry you're going through this pain. I am also not happy with my results and I am having pain on a daily basis. I am 5 months out and my dr. Is asking me to wait a little longer and force a pump on to get my toe use to the pressure or I would call it pain.  If time doesn't heal this by January I'm getting it removed and he is going to shave down the bone spur (located on top of metatarsal) that is causing some of the pain. (He wouldn't remove bone spur because he wanted more support for the cartiva. ) Good luck to you, I hope you find relief in something.

Were you having pain at the sesmoid before the surgery? It sounds like you got no pain relief from this cartiva, which I am sorry to hear. Have you tried the shoe insert with cut out hole and turf toe plate? Is that something that will have to be special made for you? Is surgeon thinking being ANA positive has something to do with cartiva not working. I thought just ANA positive alone really doesn't mean you have any kind of documented autoimmune disease. Has surgeon ordered an MRI of your foot?

Nancy,

Have you been able to walk without Mortons extensions without pain? Do you have ROM  after the surgery? Did you have it before? Sounds like your recovery is going well.

Do you feel like your pain is due to the big bone spur on the top of your foot? Usually they remove that when the place the implant in. Are you having pain underneath  your foot at the ball of the foot as well? Do you have range of motion? I hope you get out of pain. At 5 months I could see where there would be some swelling but you should not be in pain with every step. Can you get into any shoes?

Can I ask why your doctor is saying it is due to previous cheliectomy as most surgeons do a cheilectomy when the put in the cartiva. In your case, the cheliectomy had already been done. Is surgeon saying that you did not have enough bone left to get cartiva in properly? I would have thought that could be figured out from xray and MRI preop, but IDK. I would get another opinion.

Where are you feeling the pain?

Thanks jocat.  I'm sorry about your pain too.     But to clarify - did you say force a pump on - as in a SHOE?  like women's heels?  I couldn't even begin to imagine trying to do that. The pain would be unbearable!  Not sure even successful cartiva people should do that? lol

Hi Karen - he did not give me specific reasons. I just took it to mean due to my long term inflammatory issues. The 2nd opinion guy I just went to saw absolutely nothing wrong with either of my bones and the cartiva placement. He showed me where they had shaved down the bone spur. He did say there was a piece of the toe bone itself (above the cartiva implant) that he may have taken off, but he felt it was a minor thing.  The tricky thing about arthritis is that it doesn't show up accurately on an xray.  So each time my toe had been worked on - the arthritis was much worse that anticipated - per the surgeon.  My x ray showed no more than stage 2, but i was definitely stage 3 +.  He was not expecting that.

Oh sorry - also - i have the pain in the joint itself, and under the joint (on the bottom of my foot) the sesmoid.

I only have the metal plates in my walking shoes to protect the joint. I wear sketchers go walks to work everyday and exercise my toe constantly, it hurts the most whenever I exercise it, and sometimes it hurts underneath the toe.  Sometimes I get horrible shooting pains in the toe area but it stops after awhile. My doctor would not clean out any bone spurs or fix my bunion during the surgery. He refused to do anything but put the implant in. So I still have a bone spur there. Listen, what ever ROM I get will be fine as long as the pre op pain is gone! I didn't have much ROM to begin with in that toe due to arthritis. 

The pain is different then pre surgery pain.  It's in the center of the joint.  I still get arthritis pain but I had surgery done on my other big toe 3 years ago ( not an implant) and still get that so I wasn't looking for a miracle just something less then what I'm feeling.  The bone spur was not being taken off because he wanted it to help support the implant. My rom is great it always has been though.  I have absolutely no cartilage left in my big toes.  Reason why I went for cartiva. But I personally prefer the arthritis pain instead of the pain I get with this implant. Dr seems to think that because my ROM is so good that when I walk it's hitting the bone spur and that is causing the pain. I don't have pain on the bottom it's only in the center and some on top of joint. (On top is  where the bone spur is) 

Lol yea as in a pump.  His words to me is that he would have thought I would be in a small pump by 3 months. Obviously I can't at all and I'm at 5 months.  I was out of work for 11 weeks because I couldn't get a closed toe shoe on , so honestly this hasn't been a good experience for me and I had the other foot done 3 years ago without an  implant and just scraping the arthritis off and bone spurs with tiny holes drilled into the metatarsal so my body would generate health tissue.  Still have arthritis pain but at least I can tolerate a pump.

Karen,

I had to really think on the sesmoid. I believe the pain started post the chielectomy a couple years ago, and really just on and off since then.  I had no idea it was a completely different joint/bone!  I haven't gone for the fitting yet for the insert (just went to the dr last friday PM).  Yes - it has to be special made per surgeon rX.  And yes, you are correct, people can be ANA positive without any clinical symptoms. If you are interested in all of my symptoms & my specific bloodwork results (which I have been getting every 6 months for the last 6 yrs) and my family history of RA & Lupus - PM me privately.  Probably not the right forum to talk specifics of autoimmune diseases!   Neither surgeon has ordered an MRI at this point.  I suppose I could force the issue and request one.  Hadn't considered it, to be honest!