DETROIT – Orthopedic surgeon Dr. Matthew Brewster had long sought a better treatment option for his younger, still-active patients suffering from arthritic joint pain in their big toe.
The gold standard for moderate to severe big-toe arthritis — a fusion of the bones — could relieve their pain but permanently rob them of mobility in the toe, limiting their ability to partake in athletic activities such as jogging and wearing heels.
"I didn't like fusing 55-year-old women's toes that want to run and wear heels," said Brewster, who practices at Associated Orthopedists of Detroit.
So when the U.S. Food and Drug Administration last July approved the first synthetic cartilage-like implant as a treatment for big-toe arthritis, he signed up. Brewster performed his first procedure with the Cartiva implant that month, helping a 62-year-old Clinton Township, Mich., woman regain the ability to wear shoes without pain and even go running. She became only the second U.S. patient to receive the implant, which has been available in Europe for more than a decade.
Brewster has since successfully treated 13 patients with the implant. All of them were relieved of their pain and kept about half of their pre-arthritis joint mobility, he said.
Although the implant material is only approved in the U.S. for the big toe, it has been successfully used to treat arthritic thumbs and knees in Canada and Europe and offers hope for the millions of arthritis sufferers who wish to remain active and avoid joint replacements that steal their mobility and require extensive surgeries once the devices wear out.
An estimated 2.7 million middle-aged people in the U.S. have big-toe arthritis.
Brewster's patients' health insurance agreed to cover the Cartiva implant and procedure costs, which are said to be slightly higher than a standard bone fusion.
