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Revision of Synthetic Cartilage Implant Hemiarthroplasty of the Great Toe to Metatarsophalangeal Joint Arthrodesis

Technique and Indications

Davies, Mark B., FRCS (Tr & Orth)*; Roberts, Veronica I., FRCS (Tr & Orth)*; Chadwick, Carolyn, FRCS (Tr & Orth)*; Glazebrook, Mark A., MD, PhD, FRCSC

doi: 10.1097/BTF.0000000000000197
Technique: PDF Only

The use of a polyvinyl alcohol hydrogel synthetic cartilage implant hemiarthroplasty for osteoarthritis of the first metatarsophalangeal joint has increased since publication of the results of a pivotal, prospective, randomized, multicenter, noninferiority, clinical trial performed in the United Kingdom and Canada. The synthetic cartilage implant was awarded FDA approval in July 2016, permitting its commercial distribution in the United States, which has led to a notable escalation in its use. Concomitant failures in a small proportion of these patients will require conversion to arthrodesis. This study describes the surgical technique used to convert synthetic cartilage implant hemiarthroplasty of the first metatarsophalangeal joint to arthrodesis and the 3 cases that underwent revision at a single center in the United Kingdom.

Level of Evidence: Diagnostic Level IV, case series. See Instructions for Authors for a complete description of levels of evidence.

*Sheffield Foot and Ankle Unit, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

Dalhousie University and Queen Elizabeth II Health Sciences Center, Halifax, NS, Canada

M.B.D. received support for travel to meetings and payment for development of educational presentations from Cartiva Inc. M.A.G. received consulting fees, support for travel to meetings, and an institutional grant for research and institutional support for the original randomized clinical trial from Cartiva Inc.; consulting fees outside the scope of the current work from Wright Medical/BMTI, Smith & Nephew, Ferring Inc., and BioSET Inc., and institutional research grants outside the scope of the current work from Wright Medical/BMTI, Smith & Nephew, Ferring Inc., and BioSET Inc. Cartiva Inc. paid an independent medical editor directly for assistance with preparation of the manuscript. The remaining authors declare no conflict of interest.

Address correspondence and reprint requests to Mark B. Davies, FRCS (Tr & Orth), Sheffield Foot and Ankle Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. E-mail:

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