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International Orthopaedics

, Volume 36, Issue 9, pp 1865–1869 | Cite as

The long-term outcome of silastic implant arthroplasty of the first metatarsophalangeal joint: a retrospective analysis of one hundred and eight feet

  • Samer MorganEmail author
  • Aaron Ng
  • Tim Clough
Original Paper

Abstract

Purpose

The short-term results of silastic implant of the first metatarsophalangeal joint (MTPJ) have been successful. However, reservations exist regarding long-term results. The aim of this study was to evaluate long-term outcome of silastic implant prosthesis in treatment of hallus rigidus.

Methods

This was a retrospective study, with 108 feet in 83 patients, operated upon between 1988 and 2003. Mean age at operation was 55 years (SD 8.1) with a follow-up period of 8.5 years. Outcome measures included the American Orthopaedic Foot and Ankle Scoring system(AOFAS), passive and active arc of motion. Patients’ satisfaction was assessed using the visual analogue scale. All the patients had anteroposterior and oblique views and were assessed for loosening and osteolysis. Pedobarographic studies were performed using the Musgrave Footprint. Complications and revisions were recorded.

Results

The mean total AOFAS score was 77.5 (SD 13.4). Mean active and passive arc of motions were 36.8 degrees (SD 19.13) and 46.82 degrees (SD 17.19), respectively. Patient satisfaction showed mean VAS of 7.73 (SD 2.41). Prostheses were removed in three feet at three, five and seven years respectively because of persistent pain. Radiologically 25 feet (23 %) had osteolysis but were non progressive and didn’t correlate with the functional outcome.

Conclusion

We can conclude that silastic implant arthroplasty is an effective procedure in hallux rigidus management with satisfactory functional outcome and high patient satisfaction.

Keywords

Plantar Pressure Metatarsal Head Metatarsophalangeal Joint Occasional Pain Satisfactory Functional Outcome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Swanson A, Biddulph SI, Hagert CG (1971) A silicone rubber implant to supplement the Keller toe arthtroplasty. NY Univ Inter Clin Inform Bull 10:7–14Google Scholar
  2. 2.
    Swanson A, Lumsden R, Swanson G (1979) Silicone implant arthroplasty of the great toe: a review of single stem and flexible hinge implant. Clin Orthop 142:30–42PubMedGoogle Scholar
  3. 3.
    Miller R, Ratton N, Sorto L (1983) The geriatric bunion: correction of metatarsus primus varus and hallux valgus with the Swanson total joint implant. J Foot Surg 22:263–270PubMedGoogle Scholar
  4. 4.
    Cracchiolo A, Swanson A, Swanson G (1981) The arthritic great toe metatarsophalangeal joint: a review of flexible silicone implant arthroplasty from two medical centers. Clin Orthop 157:64–69PubMedGoogle Scholar
  5. 5.
    Needleman L (1995) The microscopic interaction between silicone and the surrounding tissues. Clin Podiatr Med Surg 12:415–423Google Scholar
  6. 6.
    Vanore J, O’Keefe R, Pikscher I (1984) Complications of silicone implants in foot surgery. Clin Podiatr 1:175–198Google Scholar
  7. 7.
    Mondul M, Jacobs PM, Caneva RG, Crowhurst JA, Morehead DE (1985) Implant arthroplasty of the first metatarsophalangeal joint a 12 year retrospective study. J Foot Surg 24:275–279PubMedGoogle Scholar
  8. 8.
    Romash MM (1995) Commentary on survivorship analysis of implant arthroplasty for the first metatarsophalangeal joint. ADV Orthop Surg 19:120–122Google Scholar
  9. 9.
    Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M (1994) Clinical rating systems for the ankle-hindfoot, midfoot, hallux and lesser toes. Foot Ankle Int 15:349–353PubMedGoogle Scholar
  10. 10.
    Kaliszer M, O'Flanagan S, McCormack B, Mulhall J, Heavey A, Shehan J (1989) Setting the baseline parameters for clinical assessment of foot to ground contact using the Musgrave pressure plate system. J Biomed Eng 11:30–34Google Scholar
  11. 11.
    Bonet J, Taylor D, Lam AT, Williams E, Kean LA (1998) Retrospective analysis of silastic implant arthroplasty of the first metatarsophalangeal joint. J Foot Ankle Surg 37:128–134PubMedCrossRefGoogle Scholar
  12. 12.
    Lemon B, Pupp GR (1997) Long term efficacy of total silastic implants: a subjective analysis. J Foot Ankle Surg 36:341–346PubMedCrossRefGoogle Scholar
  13. 13.
    Swanson AB (1972) Implant arthroplasty of the great toe. Clin Orthop 85:75–81PubMedCrossRefGoogle Scholar
  14. 14.
    Swanson A, Swanson G, Maupin B, Shi S, Peters JG, Alander DH, Cestari VA (1991) The use of grommet bone liner for flexible hinge implant arthroplasty of the great toe. Foot Ankle 12:149–155PubMedGoogle Scholar
  15. 15.
    Granberry W, Noble P, Bishop J, Tullos HS (1991) Use of a hinged silicone prosthesis for replacement arthroplasty of the first metatarsophalangeal joint. J Bone Joint Surg 73-A:1453–1459Google Scholar
  16. 16.
    Kampner SL (1984) Total joint prosthetic arthroplasty of the great toe—a 12 year experience. Foot Ankle 4:249–261PubMedGoogle Scholar
  17. 17.
    Pontell D, Gudas C (1988) Retrospectiveanalysis of surgical treatment of hallux rigidus/limitus: clinical and radiographic follow up of hinged, siliastic implant arthroplasty and cheilectomy. J Foot Surg 27:503–510PubMedGoogle Scholar
  18. 18.
    Ris HB, Mettler M, Engeloch F (1988) Langzeitergebnisse mit der Silastik-Endoprothese nach Swanson am Grosszehengrundgelenk. Diskrepanz zwischen Klinik und radiologischem Befund. Zeitschr Orthop 126:526–529CrossRefGoogle Scholar
  19. 19.
    Daniilidis K, Martinelli N, Marinozzi A, Denaro V, Gosheger G, Pejman Z, Buchhorn (2010) Recreational sport activity after total replacement of the first metatarsophalangeal joint: a prospective study. Int Orthop 34:973–979PubMedCrossRefGoogle Scholar
  20. 20.
    Worsing BA, Engber WD, Lange TA (1982) Reactive synovitis from particulate SILASTIC. JBJS 64:581–585Google Scholar
  21. 21.
    Papegelopoulos PJ, Kitaoka HB, Ilstrup DM (1994) Survivorship analysis of implant arthroplasty for the first metatarsophalangeal joint. Clin Orthop 302:164–172Google Scholar
  22. 22.
    Weissman B (1985) Radiographic evaluation of total joint replacement. In: Kelly WN, Harris N, Ruddy S, Sledge CB (eds) Textbook of rheumatology, 2nd edn. Saunders, Philadelphia, p 1971Google Scholar
  23. 23.
    Vanore J, O’Keefe R, Pikscher I (1984) Silastic implant arthroplasty. J Am Podiatr Assoc 74:423–433Google Scholar
  24. 24.
    Hanft JR, Merrill T, Marcinko DE, Mendicino R, Gerbert J, Vanore JV (1996). Grand rounds: first metatarsophalangeal joint replacement. J Foot Ankle Surg 35:78–85Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.SpR Trauma and OrthopaedicsWiganUK
  2. 2.Wrightington HospitalAppley BridgeUK

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