Sience my doctorate is in anthropology, i''m not particularly qualified to answer your question. The Cartiva implant has been used in Europe and Canada for 5 plus years but was just recently approved by the FDA. I was the third person in Seattle to have the surgery, all by the same doc. It took the doctor 23 minutes, which tells something about the complexity. Prior to surgery I had been living with arthritis and bone on bone, which was quite painful. The surgery was June 5, about 3 weeks ago. I walked out of the hospital and 11 days later I was no longer using the "boot". I just returned from an hour of fast paced cycling and went 45 min yesterday. My pain is at about a 3. I only needed 5 pills for pain after the surgery, 1.5 day's worth. Mobility is very good. I keep working on it.