When painkillers stop working, a small arthritic joint damage, in the toe, can feel like a weight of a bedsheet and cause agonising pain. For a 52-year-old man, for whom, even performing simple daily tasks were daunting. He has been suffering a progressive, worsening pain in his big toe for years.
Due to which, he could no longer wear shoes and doctors diagnosed him with osteoarthritis. He became the first Indian to undergo the new and revolutionary toe implant surgery performed at Sahyadri Super Speciality Hospital, Hadapsar, Pune.
The Cartiva synthetic cartilage implant was performed live during the 10th Parekh Indo-US Foot and Ankle Surgery Conference by eminent surgeon Dr Selene Parekh, Orthopaedic Foot and Ankle Specialist, Professor – Department of Surgery, Duke University, U.S.A. and Dr. Sampat Dumbre Patil, Director – Orthopaedics, Consultant Foot and Ankle Surgeon, Sahyadri Super Speciality Hospital, Hadapsar, Pune.
This 45-minute-long surgery was broadcasted live to doctors and surgeons who attended the conference. The conference also witnessed another rare ankle replacement surgery which was also was relayed live.
Osteoarthritis, a chronic, progressive musculoskeletal disorder is characterized by gradual loss of cartilage in joints, which results in bones rubbing together and creating stiffness, pain, and impaired movement. The disease commonly affects the joints in the knees, hips, hands, feet, and spine.
Often, it is associated with modifiable and non-modifiable risk factors such as obesity, lack of exercise, genetic predisposition, bone density, occupational injury, trauma, and gender.
Arthritis of the big toe, or Hallux Rigidus, affects about one in 40 Indians over the age of 50. “We walk with a rocking motion, pushing off with the big toe with every step. Most people don’t realize how much you use your big toes and how difficult it is to do simple things, like walk, when you are in so much pain.
Over time, the cushioning cartilage that stops the ends of the bones rubbing together can wear away, and the joint becomes stiff and painful. Painkillers can help and so can steroid injections.
However, it can get worse, if all else fails; we replace the joint, or fuse the end of the foot bone to the toe bone. This means it’s rigid, and can no longer move, so the toe is no longer painful, but also restricts mobility,” explains Dr Sampat Dumbre Patil, Director, Orthopaedics, Consultant Foot and Ankle Surgeon, Sahyadri Super Speciality Hospital, Pune.
Doctors say the problem with traditional implants for the big toe is the relatively high complication rates and how they often don’t last beyond seven years. Cartiva Inc’s implant – made of the same substance used in contact lenses, called hydrogel was first used in Canada and has now become a worldwide practice. The implant eliminates arthritic pain in the big toe and enables patients to regain mobility and return to a healthy, active lifestyle by providing cushioning in between the bones.
For the first time in India, this procedure was used as part of a non-profit activity by The Parekh Family Foundation with the support of Sahyadri Hospital and was completely free-of-cost. The doctors’ team included surgeons from India and the U.S.A – Dr Sampat Dumbre Patil, Dr Selene Parekh, Dr Rob Holloway, Dr Bonnie Chen, Dr Danny Scott, and Dr Malhar Dave.
“The Cartiva cartilage works like a bumper over the joints and is inserted into the base of the big-toe through a drilled hole. It is ideal for people in their 40s and 50s who want to continue running, using the elliptical, wearing high heels, etc.,” said, Dr. Selene Parekh, Orthopaedic Foot, and Ankle Specialist, Professor – Department of Surgery, Duke University, U.S.A.
Dr Selene added, “The patient was discharged on the next day and will be able to resume daily activities within four weeks. Up until now, there truly were no viable options for those who wanted to remain active. That’s why so many people in India choose to continue living with the pain. With this implant, essentially, we are changing the way we treat arthritis of the small joints.”