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Expert Opinions: Toe Hemiarthroplasty vs. Fusion

The standard of care for advanced toe arthritis has always been arthrodesis. Historically, scientific literature favored joint fusion, however, metatarsal based implants have now been in use for over a decade allowing motion preserving joint replacements to gain traction for the treatment of Hallux Rigidus.

A recent systematic review of peer review literature showed that Toe HemiCAP® implant surgery had a larger impact on patients’ pain relief when compared to fusion. Patients’ satisfaction was also rated higher with joint replacement when compared to fusion. Joint arthrodesis is considered an end stage procedure in all other joints, however, in the toe it is still considered as a primary procedure. Particularly for patients with mobile arthritis, it may be time to rethink the treatment approach as the published reoperation rate for fusions was 3 times higher than the metatarsal based HemiCAP implantations. Based on these literature results, HemiCAP joint resurfacing surgery may be a suitable alternative to fusion and should be considered as a first implant for Grade II and III Hallux Rigidus.

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