The GAIT Implant spacer is designed for replacement of the 1st metatarsophalangeal joint. The GAIT MPJ prosthesis is constructed of medical grade silicone elastomer and is available in three sizes: small, medium, and large. Individual color-coded sizers are available.
The GAIT spacer procedure is reserved for class 3 Regnauld type degeneration of the 1st metatarsophalangeal joint with narrowing of the joint space, loss of the joint cartilage, bony spurring surrounding the joint space, and a painful range of motion of the 1st metatarsophalangeal joint both with rotation and with walking.
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60/60 is the criteria for this implant: over 60 years of age, or less that 60% of a normal push-off ability.
The benefit of the surgery is to allow regular walking without the accompaniement of the degenerative arthritic pain.
This type of
surgical correction is not expected to recreate a normal range of motion of the first metatarsophalangeal joint. The implant is a spacer meant to augment the Keller arthrtoplasty procedure by stabilizing the hallux to the first metatarsal head in the transverse, sagittal and frontal plane.
Step One:
Perform a Keller type arthroplasty excising approximately ten millimaters (1/3) off the proximal phalanx base.
Step Two:
Remove the dorsal and medial bony exostosis from the first metatarsal head.
Step Three:
Remove the fibular sesamois if it is indicted and appropriate.
Step Four: Drill a hole through the cartilage into the first metatarsal head and shaft. Use a broach and sizers for the final size and fit.
Step Five: Drill a hole into the proxiamal phalanx stump. Use a broach and sizers for final size and fit.
Step Six:
Copiously flush with an antibiotic solution of your choice.
Step Seven (a): Place a hinge facing up for regular
use. This reduces the fracture tendency as there is less
rotational pressure on the hinge.
Step Seven (b): Place the implant with henge facing down across the arthroplasty space for improved toe purchase. This places more rotation pressure on the hinge.
Step Eight:
Close the joint capsule to cover the implant and stabilize the hallux to the first metatarsal.
Step Nine:
If the exterior hallucis longus tendon is out of balance, lengthen appropriately.
Step Ten:
Close the superficial fascia and skin in the usual manner
