The June 2019 cover story, “Addressing First MPJ Arthritis: A Roundtable Discussion,” published in Podiatry Today, provides the reader with an overview of current non-surgical and surgical options for the management of first MPJ osteoarthritis.1 When considering treatment options, it is important that solutions are presented in a fair and balanced manner to provide the reader with an unbiased overview. It is equally important for a publication to disclose potential conflicts of interest or consulting agreements on behalf of the roundtable panelists to ensure the reader understands potential bias in the editorial. As such, I would like to take this opportunity to correct information presented in the recent roundtable discussion and offer some additional commentary.
First, the published results from the Cartiva synthetic cartilage implant clinical trial at two years and the midterm 5.8 year follow-up list the surgeons involved in these studies.2,3 No members of this roundtable discussion were involved in this clinical trial and furthermore, the Cartiva implant was not commercially available for use in the United States until after completion of the original clinical trial.
Secondly, no disclosures of financial involvement with industry were provided for the roundtable participants. In the absence of this provision, readers should be aware of payments made by drug and medical device companies to physicians that are made publicly available each year by the Centers for Medicare and Medicaid Services. Payments to physicians can be viewed by searching the Open Payments Database at www.openpayments.cms.gov . How surgeons are financially motivated should be considered as part of their commentary on recommended treatment solutions.
I respect the authors’ opinions but there are things that I disagree with based upon my own personal experiences using the Cartiva implant. I will offer that I am a consultant for Wright Medical paid to educate my fellow podiatric community on the use of the Cartiva synthetic cartilage implant.
When the Cartiva implant was first introduced, I carefully reviewed the clinical trial data and recommendations from the company. In my practice, my patient follow-up results closely mirror those presented in the clinical trial. I believe my results are a function of proper patient selection, counseling my patients on what to expect postoperatively and staying the course in postoperative care. The data clearly demonstrates that it may take six months to one year for patients to fully appreciate the benefits of the Cartiva implant and this has also been my experience.
Lewis Freed, DPM
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1. Hyer C, Baravarian B, Brandao RA, Bull PE, Fidler C, Watson BC. Addressing first MPJ arthritis: a roundtable discussion. Pod Today. 2019;32(6): 22-30.
2. Baumhauer JF, Singh D, Glazebrook M, et al. Prospective, randomized multi-centered clinical trial assessing safety and efficacy of a synthetic cartilage implant versus first metatarsophalangeal arthrodesis in advanced hallux rigidus. Foot Ankle Int. 2016;37(5):457-469.
3. Glazebrook M, Blundell C, O’Dowd D, et al. Midterm outcomes of a synthetic cartilage implant for the first metatarsophalangeal joint in advanced hallux rigidus. Foot Ankle Int. 2019;40(4):374-383.