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The use of grommets for flexible hinge toe implants. A case report
H Ishikawa1, T Hanyu, A Murasawa
1Department of Orthopaedic Surgery, Niigata Prefectural Senami Hospital, Murakami, Japan.
Clinical Orthopaedics and Related Research
|July 1, 1995
Summary
Grommets may enhance the durability of first metatarsophalangeal toe implants and prevent silicone synovitis. Postmortem examination revealed implant damage without grommets, but not with them.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Rheumatology
Background:
- Rheumatoid arthritis often necessitates joint replacement surgery, including first metatarsophalangeal (toe) implants.
- Flexible hinge toe implants are used to address pain and deformity associated with rheumatoid arthritis.
- The long-term durability and potential complications of these implants require thorough investigation.
Observation:
- A postmortem examination was conducted on bilateral first metatarsophalangeal flexible hinge toe implants from a 66-year-old woman with rheumatoid arthritis.
- One implant was inserted with grommets, while the contralateral implant was inserted without grommets.
- Both implants had been in situ for 2.5 years prior to the patient's death.
Findings:
- Microscopic and surface analysis revealed silicone particles and significant surface wear (tear and scuffing) in the implant *without* grommets.
- The implant *with* grommets showed no such particulate debris or surface degradation.
- These findings indicate a protective effect of grommets on implant integrity.
Implications:
- Grommets may play a crucial role in improving the longevity and performance of flexible hinge toe implants.
- The use of grommets could potentially mitigate the risk of silicone synovitis, a known complication of silicone implant wear.
- Further research into implant design modifications, including the use of grommets, is warranted to enhance patient outcomes in rheumatoid arthritis treatment.