How To Salvage A Failed First MPJ Implant

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Here is a preoperative radiograph of a symptomatic failed silastic implant with varus subluxation of the hallux on the second and third digits. This anterior-posterior view shows extensive cystic change of the proximal phalanx and the first metatarsal hea
These intraoperative photographs show the first metatarsophalangeal joint with the silicone implant removed. Note the erosion of the proximal phalanx and the first metatarsal head.
This intraoperative photograph shows the structural tricortical iliac crest graft.
This intraoperative photo shows the graft in place with internal fixation.
These intraoperative photographs show the first metatarsophalangeal joint with the silicone implant removed. Note the erosion of the proximal phalanx and the first metatarsal head.
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Author(s): 
By Graham A. Hamilton, DPM

1. Swanson AB. Implant arthroplasty for the great toe. Clin Orthop 1972;85:75-81.
2. Swanson AB, Lumsden RM, Swanson GD. Silicone implant arthroplasty of the great toe. A review of single stem and flexible hinge implants. Clin Orthop 1979 Jul-Aug;(142):30-43.
3. Albin RK, Weil LS. Flexible implant arthroplasty of the great toe: An evaluation. J Am Podiatry Assoc 1974 Dec;64(12):967-975.
4. Cracchiolo A 3rd, Swanson A, Swanson GD. The arthritic great toe metatarsophalangeal joint: a review of flexible silicone implant arthroplasty from two medical centers. Clin Orthop 1981 Jun;(157):64-9.
5. Gould N. Hallux rigidus: cheilotomy or implant? Foot Ankle 1981 May;1(6):315-20.
6. Kampner SL. Total joint prosthetic arthroplasty of the great toe--a 12-year experience. Foot Ankle 1984 Mar-Apr;4(5):249-61.
7. LaPorta GA, Pilla P Jr, Richter KP. Keller implant procedure: a report of 536 procedures using a Silastic intramedullary stemmed implant. J Am Podiatry Assoc 1976 Mar;66(3):126-47.
8. Wenger RJ, Whalley RC. Total replacement of the first metatarsophalangeal joint. J Bone Joint Surg Br 1978 Feb;60(1):88-92.
9. Kitaoka HB, Holiday AD Jr, Chao EY, Cahalan TD. Salvage of the failed first metatarsophalangeal joint implant arthroplasty by implant removal and synovectomy: clinical and biomechanical evaluation. Foot Ankle 1992 Jun;13(5);243-50.
10. Koenig RD. Revision arthroplasty utilizing the Biomet Total Toe System for failed silicone elastomer implants. J Foot Ankle Surg 1994 May-Jun;33(3);222-7.
11. Granberry WM, Noble PC, Bishop JO, Tullos HS. Use of a hinged silicone prosthesis for replacement arthroplasty of the first metatarsophalangeal joint. J Bone Joint Surg Am 1991 Dec;73(10):1453-9.
12. Ris HB, Mettler M, Engeloch F. [Long-term results using a Swanson silastic endoprosthesis of the metatarsophalangeal joint of the great toe. Discrepancy between clinical and radiologic findings] [Article in German]. Z Orthop Ihre Grenzgeb 1988 Sep-Oct;126(5):526-9.
13. Shankar NS. Silastic single-stem implants in the treatment of hallux rigidus. Foot Ankle Int 1995 Aug;16(8):487-91.
14. Neumann R, Reisch P. [Silastic arthroplasty of the great toe metatarsal joint] [Article in German]. Orthopade 1996 Aug;25(4);332-7.
15. Kitaoka HB, Cracchiolo A 3rd. Stress fracture of the lateral metatarsals following double-stem silicone implant arthroplasty of the hallux metatarsophalangeal joint. Clin Orthop 1989 Feb;(239):211-6.
16. Lemon RA, Engber WD, McBeath AA. A complication of Silastic hemiarthroplasty in bunion surgery. Foot Ankle 1984 Mar-Apr;4(5):262-6.
17. Shereff MJ, Jahss MH. Complications of silastic implant arthroplasty in the hallux. Foot Ankle 1980 Sep;1(2):95-101.
18. Verhaar J, Bulstra S, Walenkamp G. Silicone arthroplasty for hallux rigidus. Implant wear and osteolysis. Acta Orthop Scand 1989 Feb;60(1):30-3.
19. Papagelopoulos PJ, Kitaoka HB, Ilstrup DM. Survivorship analysis of implant arthroplasty for the first metatarsophalangeal joint. Clin Orthop 1994 May;(302):164-72.
20. Bonney G, MacNab L. Hallux valgus and hallux rigidus: a critical survey of operative results. J Bone Joint Surg Br 1952 Aug;34-B(3):366-85.
21. Cleveland M, Winant EM. An end-result study of the Keller operation. J Bone Joint Surg Am 1950 Jan;32A(1);163-175.
22. Hecht PJ, Gibbons MJ, Wapner KL, Cooke C, Hoisington SA. Arthrodesis of the first metatarsophalangeal joint to salvage failed silicone implant arthroplasty. Foot Ankle Int 1997 Jul;18(7):383-90.




















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