Cartiva is a synthetic cartilage implant which has been designed to replace the damaged cartilage surface. It is made from polyvinyl alcohol (‘PVA’), a material which has been used for a number of medical device applications. The Cartiva implant in its present form has been performed over the last 8 – 9 years. A motion study, which is a multicentric study, has recently published five year outcomes. Further information on Cartiva can be found online at www.bio-bation.co.uk.
The procedure is performed as a day surgery, either under general anaesthetic or regional anaesthesia. You may be given a local anaesthetic nerve block to ensure immediate post-operative pain relief. Whilst you are in hospital you will be monitored and the medical staff will give you painkillers as required and prescribed. When you are at home you may find Paracetamol and/or anti-inflammatories useful for controlling any pain. Instructions on the management of pain will be given by the nursing staff before you leave the hospital.
In the post-operative period, in the first forty-eight hours, patients should restrict movement by only going to the toilet and elevate the leg on pillows as much as possible. Between 2 – 14 days patients should aim to move around taking gentle weight through a post-operative shoe which is to be used only when walking. During this period the leg should be elevated regularly for at least thirty minutes, three times a day at 11.00 a.m, 2.00p.m and again at 6.00p.m. At nighttime it is advisable to place a pillow under the mattress to keep the leg slightly elevated to the body position. A follow-up appointment will be made for a change of dressing and to make sure the wound has healed; at this stage self-mobilisation exercises of the big toe will also be shown to the patient. A referral for gentle physiotherapy will also be made. Patients should be able to come out of the protective post-operative shoe and go into a well-fitting, but loose-fitting shoe, such as trainers. Between 4 – 6 weeks, the foot gradually returns to normal with a reduction in swelling and patients should be able to walk reasonable distances, but not do any running, jumping or any other activities which put lot of impact on the foot. Once the wound has healed, patients can start swimming by about three weeks after the operation. The earliest physical activity patients can do around at 4 – 6 weeks, is cycling. At about three months it is expected that the majority of patients to be able to walk normally, wear loose fitting shoes and gradually resume all their activities.