Can a simple injection of stem cells into an arthritic big toe make a difference? Big toe surgery recovery can be rough. When the big toe gets arthritis, it can cause the toe to become stiff and painful. Since we use the big toe to push off when we walk, the arthritis can impact your gait. The surgical solutions to this problem aren’t pretty. The time honored big toe surgery is fusion. This is where the big toe bones are fused solid with screws (see the “Rocky Horror Show” foot above). If you’re active, not only can the recovery from this big surgery be a problem, but since the big toe needs to be flexible for normal walking, your ability to walk will never quite be the same. Another option is joint replacement, which involves an amputation of the existing joint and insertion of a prosthesis-a huge surgery given the delicate tendons, nerves, and blood vessels around the joint. What if all of this protracted surgical recovery could be replaced by a simple injection?
RA is a 69 year old man who I first evaluated in 2010 for multiple issues. His big toe had been painful for years and he was told that the only option was a surgical fusion of the joint. He was an active man in his late 60s, so the premise of fusing the toe solid didn’t fit with his lifestyle. His big toe was swollen and bent. In Jan of 2011 (more than 2 1/2 years ago), he decided to undergo the Regenexx-SD stem cell procedure instead of surgery. This involved taking bone marrow stem cells and injecting them in his arthritic toe joint under exacting imaging guidance. He had no real recovery, since a big surgery wasn’t performed. As part of a recent registry drive to get in touch with patients who were more than 2 years out from their procedure, I contacted RA. He tells me that at about 2 months after the procedure, he was walking on the beach one day with his wife when he noticed that his big toe didn’t hurt anymore. It’s been almost 100% improved since that time.
Since there is very little likelihood of a spontaneous remission of severe arthritis in a big toe that would last more than 2 years, I’ll have to assume the injection of stem cells into this area has made a lasting difference. The upshot? A huge surgery to fuse or amputate the joint or an injection? You make the call… This is the new field of interventional orthopedics at its best-replacing big surgeries with small procedures performed through tiny needles!