I’ve been an implant guy for years. Implant arthroplasty (Mayo-Keller bunionectomy) is simply what I learned to use in my residency training 25 years ago. In cases of stage 4 hallux limitus (HL), I’ll opt for a great toe implant over a fusion any day. My logic is that it’s simple; what I would want to have. I’d like to maintain my range of motion of the great toe joint.
I’ve watched with interest as the podiatry community seems to have followed the orthopedics community into a trend to fuse stage 4 HL. Fusion has long been the procedure of choice in orthopedics.
But I was heartened by several articles in The Journal of Foot and Ankle Surgery this year that have been advocating the use of implants in cases of stage 4 HL. Ironically, some were written by orthopedists (JFAS is a publication of the American College of Foot and Ankle Surgeons – the academic branch of podiatric surgery).
Sure, there are indications for great toe joint fusions, but I just can’t see using it on a regular basis when the use of an implant is a reasonable and reliable choice. Heck, foot and ankle surgeons are all gun-ho on doing ankle joint replacements. Why not the same emphasis on great toe implant arthroplasty.
Bottom line is the procedure works. Why fuse the joint?
Jeff
Jeffrey Oster, DPM
Medical Director
Myfootshop.com
Can you tell me which doctors in south Georgia have experience with mpj implants. The story I hear from every doctor I see is that mpj implants have a short life; they only last two to three years. I am also told “I’ll do the implant if that’s what you want but I don’t recommend it.” Since you’re an implant guy maybe you’ll give me the facts. What is the normal longevity for am mpj implant? I am 64 years old so I won’t be as active as a 20 year old.
I also have to get a knee replaced soon. What is the expected longevity for a knee joint implant? Should I be able to run for exercise after recuperation?
Thank you for your information.
Larry Ellis
Baxley, GA
Comment by Larry Ellis — April 2, 2009 @ 4:37 am
Hi Larry,
I’ve had implants in for over 25 years. Some in semi-pro tennis players. I think that perhaps the dark cloud that hovers over 1st mpj implants comes from the days of hemi implants. Hemi just means that half of the joint was replaced. They didn’t fair too well.
I know what you’re saying about the implants. I for one have a total hip replacement. But you know, I really believe that that my implant will last a lifetime. It’s the owner of the implant that I have to watch over. I’m active and walk 3 miles a day, mountain bike, backpack and farm. So inherent in those activities is a time when I’m certain to fall. Should I stop the activities to prevent the fall? No. You just have to approach life with a bit of balance and common sense.
When you go through a joint replacement, you’ll find friends who have been through the same thing. These friends are great int hat they can coach you and answer many of the real life questions. One of my mentors told me something that I really didn’t understand until after my hip surgery. He said, “you have to realize that it’s not real.” At first, I though well, sure, OK. but he had a good point. I have no pain on a daily basis. But my hip replacement surely wasn’t made for running. Sure, i can jog across the street, but I wouldn’t plan on running on that knee.
I don’t know many guys in the Georgia area. Is Tifton, Georgia anywhere near you? One of the fellows I trained works in Tifton. His name is Eric Massa. Real nice fellow. I think you’d like him.
Jeff
Comment by Jeffrey Oster, DPM — April 2, 2009 @ 10:00 pm
TO: Jeffrey Oster, DPM
Dr. Oster,
Tifton is well within my desired area, being about seventy-five miles away. I’ll look for information on Dr. Massa, and if I can’t locate him, I’ll ask you for it.
Thank you very much for the information and encouragement.
Larry
Comment by Larry Ellis — April 4, 2009 @ 11:45 am
Dr. Oster,
I am three weeks into recovery from my total knee replacement and am progressing well.
If a full MPJ implant fails, then what are the options?.
I have located Dr. Massa but have not yet contacted him. I want to wait another couple of weeks.
Thank you for your Help.
Larry
Comment by Larry Ellis — May 2, 2009 @ 2:56 pm
Sure thing. Glad to help. Give Dr. Massa my best. He’s a good man.
Comment by Jeffrey Oster, DPM — May 7, 2009 @ 5:50 am