Although a variety of great toe implants have been tried in an
attempt to maintain toe motion, the majority have failed with
loosening, malalignment/dislocation, implant fragmentation and bone
loss. In these cases, salvage to arthrodesis is more complicated
and results in shortening of the ray or requires structural bone
graft to reestablish length. This prospective study compared the
efficacy and safety of this small (8/10 mm) hydrogel implant to the
gold standard of a great toe arthrodesis for advanced-stage hallux
rigidus.
A prospective, randomized (2:1), controlled, noninferiority
clinical trial was performed to compare the safety and efficacy of
a small synthetic cartilage bone implant to first MTP arthrodesis
in patients with advanced-stage hallux rigidus. This study showed
equivalent pain relief and functional outcomes. The synthetic
implant was an excellent alternative to arthrodesis in patients who
wished to maintain first MTP motion. The percentage of secondary
surgical procedures was similar between groups. Less than 10% of
the implant group required revision to arthrodesis at 2 years.
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