First-ever toe implant surgery performed at city hosp

Namrata Devikar
Wednesday, 16 January 2019

Speaking to Sakal Times, Dr Sampat Dumbre Patil said arthritis of the big toe or hallux rigidus affects about one in 40 Indians over the age of 50.

Pune: When painkillers stop working, arthritic joint damage in the big toe can make even the weight of a bedsheet agonising. For a 52-year-old man, even performing simple daily tasks were daunting. He had been enduring progressively worsening big-toe pain for years and could no longer wear most types of shoes because of the pain. He was diagnosed with osteoarthritis. On January 5, this 52-year-old patient became arguably the first Indian to have undergone toe implant surgery performed at a Pune-based hospital.

Osteoarthritis is a chronic, progressive musculoskeletal disorder and is characterised by gradual loss of cartilage in joints, which results in bones rubbing together and creating stiffness, pain, and impaired movement. 

The disease most commonly affects the joints in the knees, hips, hands, feet, and spine. It is often associated with modifiable and non-modifiable risk factors such as obesity, lack of exercise, genetic predisposition, bone density, occupational injury, trauma and gender.

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 at Duke University, USA and Dr Sampat Dumbre Patil, Director, Orthopaedics, Consultant Foot and Ankle Surgeon, Sahyadri Super Speciality Hospital, Hadapsar, Pune.
The surgery took 45 minutes and was relayed live to doctors and surgeons attending the conference. The conference witnessed another rare ankle replacement surgery was relayed during this conference.

Speaking to Sakal Times, Dr Sampat Dumbre Patil said 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 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,” said Dr Dumbre Patil.

He added that 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 also restricts mobility,” said Dr Dumbre Patil. He added that this implant was never before used in India.

“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 inbetween the bones. This implant enables you to move like before. Also, its life is around seven years. But with this implant, the patient can even perform rigorous exercises like running,” said Dr Dumbre Patil.

Dr Selene Parekh, Orthopaedic Foot and Ankle Specialist, Professor - Department of Surgery at Duke University, US said 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. The patient was discharged the next day and will be able to resume daily activities within four weeks. Up until now, there 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,” said Dr Parekh.

Rare surgery performed

  • Dr Sampat Dumbre Patil and Dr Selene Parekh also performed a rare ankle replacement surgery of a 70-year-old man on January 5. Dr Dumbre Patil said the patient had undergone a fracture decades ago.
  • “The patient was bound to get arthritis at some point in time. He was unable to bear weight on one foot. We replaced the ankle joint. He will be back on his feet within six weeks and with the help of physiotherapy, we’re sure he will be able to wear shoes within 10 weeks,” said Dr Dumbre Patil.

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