[Silastic arthroplasty of the great toe metatarsal joint]

This report is based upon experience with 592 implantations of Swanson silastic spacer between 1978 and 1992. The results of 430 cases were followed up in 1995. Complications were observed in 31 cases and required further surgery. In 18 cases, the spacer was resected; in 2 cases a distal amputation was necessary. Due to pain, the spacer was changed in 11 cases, in 5 cases from a single-stem to a double-stem version. Radiological reactions increase over time following the operation without correlation to pain. The results in cases of rheumatoid arthritis and arthrosis disease are compared. Approximately 80% of the patients are free of pain and more than 90% are satisfied with the functional results. The results of the arthrosis group are slightly better.