It is implanted into bone after making a bore hole, with the native bone on the opposite side of the joint allowed to rest against it. It’s durable and has similar mechanical characteristics as natural cartilage, hopefully lasting a good deal of time.
The big advantage of the Cartiva SCI is that the toe is allowed to flex instead of remaining stiff compared to fusion surgery.
Here’s a company animation describing the implantation of the Cartiva SCI: