Abstract
Concern over long term outcomes in patients with silastic metatarsophalangeal implants prompted an assessment of such patients. We reviewed 21 single-stemmed silastic metatarsophalangeal arthroplasties in 18 patients with a mean follow-up of 18 years and 9 months. Eight operations were performed for hallux valgus, and 13 for hallux rigidus. Patients were assessed by clinical scoring, patient satisfaction, and radiographic grading. Patients treated for hallux rigidus achieved higher clinical scores than those treated for hallux valgus. This difference was statistically significant (p < 0.02). There was no correlation between radiographic appearance and clinical score, patient satisfaction, or time since implantation. Long-term changes to the bone stock did not cause clinical detriment, and in no case was late revision surgery necessary.
There has been widespread concern regarding silicone synovitis associated with early clinical detriment, together with progressive erosive bony changes seen with these implants. In our very long term review outcomes were surprisingly good, particularly in the surgical treatment of hallux rigidus in the over fifty age group.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
