A retrospective analysis of Swanson Silastic® double-stemmed great toe implants with titanium grommets following podiatric surgery for arthritic joint disease

Swanson Silastic® double-stemmed great toe implants have been used for damaged first metatarsalphalangeal joints since the early 1970s. To date, however, the efficacy of such devices have been limited to only a few studies. The aim of the study was to undertake a retrospective analysis of Swanson Silastic double-stem great toe implants focusing on pain levels, physiological function and quality of life. Ethical approval was sought and granted from Walsall Manor Hospital's Research and Ethical Committee. Cases were selected from the Podiatric Surgical Unit at the Walsall Manor Hospital. Implants in 22 feet (20 patients) were analysed at an average follow-up of 33 months (range, 9-59 months) and a mean patient age of 61 years (range, 48-80 years). Pain was significantly reduced post-operatively (P<0.005). The physiological function of the first metatarsophalangeal joint was not completely restored, showing an average hallux dorsiflexion of 21°(range, 6°-46°). Patients' quality of life, as analysed by the Podiatric Audit in Surgery and Clinical Outcome Measurement (PASCOM), demonstrated an overall success rate of 85% in relation to this sample. These data suggest that an implant arthroplasty using Swanson Silastic double-stemmed great toe implants can be effective when performed in patients who are carefully selected and manifest the proper indications for such devices. (C) 2000 Harcourt Publishers Ltd.