Silastic replacement of the first metatarsophalangeal joint: historical evolution, modern concepts and a systematic review of the literature

[摘要] Osteoarthritis (OA) of the first metatarsophalangeal joint (MTPJ) has been reported to affect between 35% and 65% of adults older than 65 years.1 The pain and stiffness associated with osteoarthritis of the first MTPJ can lead to difficulties in activities of daily living and altered gait pattern.2 End-stage arthritis or hallux rigidus has been well documented in the literature for more than a century, but a consensus on its management has not been established and, therefore, the surgical options remain controversial.3 The traditional options for operative management of endstage arthritis include excision arthroplasty, implant arthroplasty and arthrodesis. Excision arthroplasty has gradually become less popular with a limited value in current practice.3–5 Arthrodesis, popularized by McKeever in 1952,6 remains the gold standard and is the preferred choice due to its generally more predictable results, patient-reported outcomes and surgeons’ familiarity with the procedure.7 The options for replacement include a silastic (silicone) or a metallic implant. It follows the basic principles of any joint-replacement surgery aiming to reduce pain, restore joint kinematics, be long lasting and not be difficult to revise if it fails.7 Initially, silicone implants were popular among surgeons and were utilized in patients who were too young and too active for joint replacement surgery.

[学科分类] 神经科学

[关键词] first MTPJ replacement;silastic implants;silicone synovitis