A 52-year-old man, who was diagnosed with osteoarthritis, found that even performing simple daily tasks was daunting. He had been suffering from a pain in his big toe that was becoming worse, and he could no longer wear most shoes.
This week, the man became the first Indian to have undergone a toe implant surgery, which was performed at the Sahyadri Super Speciality Hospital in Hadapsar. The patient was discharged the day after the surgery and will be able to resume daily activities within four weeks.
In a statement, the hospital said the Cartiva synthetic cartilage implant was performed live during the 10th Parekh Indo-US Foot and Ankle Surgery Conference by Dr Selene Parekh, orthopaedic foot and ankle specialist, and Dr Sampat Dumbre Patil, director of orthopaedics and consultant foot and ankle surgeon at the Sahyadri Super Speciality Hospital in Hadapsar.
The 45-minute-long surgery was relayed live to doctors and surgeons attending the conference at the Suzlon Energy One Earth in Pune. Participants at the conference also witnessed another rare ankle replacement surgery, which was relayed during the event.
Osteoarthritis, a chronic and progressive musculoskeletal disorder, is characterised by gradual loss of cartilage in joints, which results in bones rubbing together and leads to stiffness, pain, and impaired movement. The disease usually affects joints in the knees, hips, hands, feet, and spine. It is often associated with risk factors such as obesity, lack of exercise, genetic predisposition, bone density, occupational injury, trauma, and gender.
Arthritis of the big toe, Hallux rigidus, affects about one in 40 Indians over the age of 50. “They walk with a rocking motion, pushing off with the big toe with every step. Most people don’t realise 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. But it can get progressively 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 this also restricts mobility,” explained Dumbre Patil.
The biggest problems with traditional implants for the big toe were the relatively high complication rates and how they often didn’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.
This week, it was used in India for the first time as part of a non-profit activity by The Parekh Family Foundation, with the support of Sahyadri Hospital, and was free of cost. “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 Parekh.