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Silicone wrist implant: long-term follow-up study
C P Comstock1, D S Louis, J F Eckenrode
1Department of Surgery, University of Michigan Hospitals, Ann Arbor.
The Journal of Hand Surgery
|March 1, 1988
Summary
Swanson design silicone rubber wrist implants showed high fracture and subsidence rates, despite pain relief for many. Long-term use led to progressive deterioration, with salvage procedures proving successful.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Rheumatology
Background:
- Silicone rubber wrist implants, specifically the Swanson design, are utilized for wrist pain management.
- Assessing the long-term efficacy and complications of these implants is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the long-term clinical and radiographic outcomes of Swanson design silicone rubber wrist implants.
- To determine the incidence of implant fracture, subsidence, and associated complications.
Main Methods:
- A retrospective study followed 19 patients with 20 Swanson wrist implants for an average of 6 years.
- Clinical assessments included pain levels, range of motion (flexion/extension).
- Radiographic evaluations assessed implant integrity, subsidence, and signs of synovitis.
Main Results:
- 65% of patients reported little to no wrist pain post-surgery.
- Average wrist flexion was 24 degrees, and extension was 21 degrees.
- Implant fracture occurred in 65%, and 100% experienced subsidence, often without clear clinical correlation. Revision surgery was needed in 30%.
Conclusions:
- Swanson implants demonstrate a high rate of fracture and subsidence, leading to progressive radiographic and clinical deterioration.
- Despite initial pain relief, long-term outcomes are concerning.
- Salvage procedures like radiocarpal arthrodesis or soft tissue arthroplasty offer successful alternatives.