Arthrosurface, Inc., a developer of joint restoration systems, has performed its first ToeMotion total toe surgery. Carl Hasselman, M.D., at the University of Pittsburgh Medical Center combined the new phalangeal implant with the HemiCAP metatarsal implants to create a total toe joint restoration.
“I have known for quite some time that the screw based fixation of the HemiCAP system is superior to any of the other press-fit solutions currently on the market. The instant fixation, immediate weight-bearing and early motion are critical to the excellent outcomes my patients have experienced with the Arthrosurface system over the past decade” said Hasselman.
The ToeMotion Total Toe Restoration System was co-designed by Arthrosurface, San Giovanni, M.D. from Doctor’s Hospital in Miami, Florida and Hasselman. The device restores mobility and maintains native biomechanics using a dual curved HemiCAP implant and a new modular tray-style phalangeal implant with a threaded base plate. The fourth generation fixation components provide stable constructs on both sides of the joint.
Giovanni commented, “Today, patients are looking for an alternative to a toe fusion in order to preserve their mobility. Although toe fusion procedures can provide pain relief, they do not restore normal biomechanics and severely limit motion. Never moving their toe again is not a very appealing option to patients.”
Steve Ek, CEO of Arthrosurface said, “We expect the ToeMotion Total Toe system to be a game changer for those patients with arthritis of the 1st MTP joint. Proven fixation with implants that restore motion is a great new option.”
Can the toemotion total toe system be used to replace a arthrosurface hemi-implant performed in 2008 which was unsuccessful?
Dear Carol,
The ToeMotion Total Joint Replacement can be used in your situation. This is one of the indications for use and would be a natural fit given that the components match each other with identical contour. Over the years I have had many successes with proper attention to detail upon placement of the implant. It is the most anatomical design of any implant on the market and a great deal of research and design went into it’s development. Having said all this, even with a great design and technically perfect implantation not every patient had a successful outcome. Success based on reduction or elimination of painful symptoms to an adequate/acceptable degree for the patient, while preserving motion that would have been lost if a fusion had been performed. Unlike historical implant failure for this joint with other designs, the mode of failure was not painful loosening of the implant. Rather in those that didn’t gain relief or symptoms progressed, the failure was due to continued pain with a stable (not loose) implant where the other side of joint (phalanx joint surface) had gone on to arthritis as well. The implant didn’t fail; the procedure failed to delivery the pain relieve desired. This frustrated me for we all want our patients happy and our procedures to be as near to 100% success rate as possible. This was my goal in designing the new ToeMotion total, by resurfacing both sides the pain would be better addressed as well as the motion. Whether you would be a good candidate depends on several factors which I can go over it with you like. If you have recent x-rays and can send them via email, it would be helpful. We can possibly Skype so I can get an idea of what it looks like clinic. Best regards, Dr. SanGiovanni drsangiovanni@gmail.com
I had hemicap put into right toe. Several months later I developed a dislocated hammer toe under second toe. I have had conflicting opinions about whether the hemicap caused this to happen. I recently had surgery to shorten the second toe. I am concerned I am sitting on a ‘time bomb’ with the hemicap in my right foot, that it can fail at any moment.
In addition, I had a hemicap put in my left foot that got infected. It was removed and antibiotic spacers were placed where the hemicap was. After six weeks, I had conflicting opinions as to whether to fuse the joint with a bone graft or perform joint interposition arthroplasty. I went with the interposition arthroplasty which seems to work very well, but again I am experiencing pain under second toe. The tendon that flexes the toe upward was damaged during the operation to insert the hemicap in the left foot The toe will not flex upward, but I can flex it downward. It seems a lot of bone has been lost and I not sure what to do if joint interposition arthroplasty fails.
The surgeon assures me he can correct all the issues with the interposition arthroplasty. Any suggestions?
To address MTP joint arthritis and bunion I had a hemicap on the right halux, post op position was off slightly to the right toward the 2nd toe. 1 year postop the halux has now drifted under the 2nd toe in a similar fashion how it presented pre-op. Can the phalangeal portion be repositioned to provide better allignment along with release of the tendons/ligaments involved to prevent relapse??? Or will I need an more involved PIP fusion/TMT fusion procedure to correct the poor anglulation??? Not hppy about the prospects of another major procedure.
6 weeks ago I had the ToeMotion implant to correct the stiff and very painful right great toe. Previous to meeting Dr. Sangiovanni I had 3 surgeries by other physicians on my right foot. Long story short: I had a failed bunionectomy where hardware fractured and required the 2nd and 3rd surgery to fix a fractured first metatarsil. This left me with a great toe joint that was rigid and increasingly so extremely painful. I was getting depressed since I needed to curtail physical activities and the outlook for me, a 59 year old very physically active (and handsome!) man, was bleak. Now with ToeMotion I am relatively pain free and am doing physical activities without any problem. At three months I am likely to have no restrictions and will be back playing golf. Too bad ToeMotion can’t improve my golf game! Obviously, I am very happy!
Kevin, how do you feel about the ToeMotion implant these days?
How do you feel after your toe motion implant?
How is your toemotion feeling now? I am considering it and want to know who they hold up
Can the HemiCap / ToeMotion system be used as a replacement for a failed Cartiva implant, where the implant recessed into the metatarsal bone?
Alan, what did you decide? My Cartiva doesn’t work for me, almost a year now, walk with pain
I am in NYC, HSS big names suggest fusion..
Alan,
What have you decided to do? What area do you live? I am still searching for the right doctor here.
Alan,
To answer your question, yes it can. We have done it and it can work well as a viable option for those in your situation that have significant residual joint pain following a failed cartiva procedure. Like anything else though much of the success and ultimate patient satisfaction relies on the details of each individual case. Whether you’re a good candidate for a Cartiva conversion to an Arthrosurface ToeMotion total joint replacement involves assessing the residual bone defect, your work/lifestyle, and your goals and expectations. It may be right for many but not for all. The same for a soft tissue interpositional arthroplasty and a 1st MTP joint fusion. There is a place and role for all of these for one may get that person where they want to be whereas to someone else it’s the polar opposite. The art lies within the decision-making and the information you provide about what you feel and want from this is just as important as the information I provide about the technical aspects and predictability of each procedure option. Long answer but a truthful one. If you like contact my office and let me know from what region of the country you’re from and I will try what I can to help you. TSG
I am a desperate person trying to find the right method for my big toe joint problem. I have stage 3 hallux rigodus with oseteoarthritis in both feet. I have a small foot like a 12 year old girl and I am 68. I worry about the implant not fitting in my toe. I also have osteoporosis in both hips. Will a toe motion implant be the best option? I live in Pittsburgh PA and I have not found anyone here for a second opinion. Can you share with me your option and also a surgeon here? I was told that someone died from this surgery. I hope and pray you respond.
Can the Arthrosurface ToeMotion system be applied to the 2nd MTPJ?
As a patient I can say the implant failed me. Not just mildly, but monument ly. I had pain and swelling for a full year after the surgery. I finally opted for the silicone device.
has anyone paid for the arthrosurface hemi cap or toe motion because their insurance doesn’t cover it? if so how much was it?
I would NOT recommend a hemicap. Ir basically crooked me for a year. Had it taken or and my toe was fused and like had been good ever since. I ran 10 miles today. I could barely walk after 3 months after hemicap.
Let’s say I am a good candidate for ToeMotion to replace a failed Cartiva. And let’s say ToeMotion also fails, what is(are) the option(s) after that? Little research suggests fusion will be the only option left. How successful is fusion after a failed ToeMotion? Recovery time? Etc.
My current Podiatrist tells me he refuses to do Arthrosurface because is not clear how to address the ones that fail, and fusion afterwards is very iffy given the amount of bone has been removed.
Four months after Cartiva implant the success is looking 50%-50%, so I still have a little bit of hope, I am just being proactive.
Thank you so much in advance Doctor for taking the time to answer our questions.
Best regards,
Mr. Leza