Doctor suggested cartiva implant but I'm sceptical

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Hi There,

Having injured my right foot (first metatarsal joint) by accidentally kicking a wall some 6 years ago, I have been trying various treatments to elevate the pain but I seem to be running out of options so I'd appreciate any suggestions you folks might have for me.

To give some background: after first sustaining the injury, I gave the foot a couple weeks some rest to see if it would heal itself. The pain reduced somewhat but I still had pain during and after jogging or even walking.

I had an X-ray and MRI after which the doctor suggested surgery involving "de-burring" of the bone and creating a "new scar". I was (and am) in my 30's so I didn't like the sound of such a drastic approach nor the risk of infection/complications so continued the route of rest-will-cure-all!

The MRI showed oedema of the bone and a (possible) cystic change. having done an MRI again in 2018, there is not much change.

I have attached a comparison showing MRI scans if it helps understand whats going on.

Another doctor agreed and told me to stay off the foot as much as possible and use anti inflammatory pills when needed.

So in late 2018 with zero improvement, I went another doctor who suggested steroid shots and if that didn't work, a Cartiva implant I had the steroid shot which helped for a month and a second one earlier this year, which again helped for a month. So, I'm wondering if I am really out of options? Do I really need a Cartiva implant? or even a joint fusion? If I do either is it guaranteed to eliminate the pain?

The toe does not hurt when I flex it up and down.. the pain only comes when I put weight on it when walking. Using a big toe divider helps for some reason.
I really miss jogging and my ultimate goal would be to solve this thing and not deal with days of pain after jogging 5km. So, any help to find alternative solutions would be much appreciated!