First MTP Arthritis, Is There a Way We Can Keep Motion?

Cartiva was marketed as "synthetic cartilage replacement" for the first MTP. With great fanfare, this technology was acquired by Wright Medical Technologies in 2018 after a multi-party bidding war, for $435 million. The market reception has been mixed, but most agree that the indications for Cartiva are narrower than may have been implied.

Conflicting evidence

Initial studies to support the FDA panel approval were strong and encouraging, though more recent reports call into question the methodologies of the studies.

Cartilage resurfacing instead of prosthetic replacement or fusion?

Cartilage repair for focal osteochondral defects of the first MTP may be a strategy before fusion or arthroplasty. Osteochondral plugs and resurfacing both have advocates. Although still at the case report stage, the experience is improving in the literature.