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Cartiva Synthetic Cartilage Gives an Alternative to Fusion

Randee Lieppe's injury to her big toe caused her to put away her high heels and changed how she lived her life.  At first cortisone shots helped but she then developed arthritis and a bone spur in her big toe. 

"I was miserable."

Any movement in Randee’s big toe would cause excruciating pain. Her only option was fusion surgery that would have left her without motion in her toe and a long recovery. Then Dr. John Gleason told her about a new FDA approved procedure; the Cartiva implant.

“It's spongy like silicon but firmer so it gives resistance. It relieves the pain, similar to a fusion, but it maintains the motion.”

Cartiva is revolutionary technology and the only synthetic cartilage approved in the United States. Created by Georgia Tech and manufactured locally in Alpharetta it is quickly gaining popularity. Dr. Gleason expects Cartiva synthetic cartilage will soon be used in other joints like knees and hands. 

"If it can hold up to the stress of the forces that go across the big toe then it will be successful in other joints too."

Randee Lieppe is glad to have the Cartiva implant. 

"I love it, it’s great! I'm back in my heel and starting to get back to my normal lifestyle, which is really nice."



Dena Byars' big toe had become a big pain.

"I got to the point where I was wearing not only flat shoes, but I couldn't wear any enclosed shoe at all," Byars says.

The 59-year-old high school chemistry teacher from Troy, Alabama diagnosed was with osteoarthritis in her big toe and says she spent 20 years in pain.

By early 2018, she was living in flip flops. And it wasn't just that.

"I couldn't walk up the stairs because I couldn't flex the joint," Byars says. "It would be bone grinding against bone. And it didn't just hurt then. I would wake up at night in pain if I had walked a lot that day."

Byars was told she needed fusion surgery. That would stop the pain but would leave her unable to flex her big toe. So, in the spring of 2018, she went online to look for a better option.  "I just Googled it, and when I found it, I drove up to Atlanta," Byars says. "I'm in southeast Alabama."

Byars found Dr. John Gleason of Resurgens Orthopaedics in Sandy Springs.

Gleason is using a synthetic cartilage implant known as Cartiva, developed at Georgia Tech and manufactured in Alpharetta.

The doctor says Cartiva is made of a polymer that acts a lot like the natural cartilage Dena Byars has lost to wear and tear over the years. The joint surgery takes about 35 minutes, he says, and it is performed as an outpatient procedure under general anesthesia. "So, we drill a hole in the end of the bone and place this material in there in place of the cartilage," Gleason says. "It's usually only on one side. So, it acts like a buffer or cushion between the two bones."

The implant, approved by the FDA more than two years ago, has been studied for six years in other countries.  Dr. Gleason says the data has been positive.  "Those studies they've done, the six-year studies, show pretty remarkable success," he says.  "A greater than 95 percent success rate. The failure rate is typically easy to resolve, in that the patient can go back and have a fusion done."

Resurgens is performing about 12 to 15 surgeries a month using Cartiva, which, Gleason says, holds up better than previous implants they've used in the big toe.  Byars had her surgery on June 14, 2018. "It's the best day's work I've ever done," she says. "I can walk up stairs now. My office is on the third floor. And I get so excited because I can do that. I can do Pilates. I can go hiking. Just huge life change, just from a toe."

No more flip flops for this teacher.  "(I like) just being able to buy normal shoes," Byars says.  "But on top of that, I can buy cute ones now, too!"

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