Silicone lymphadenopathy associated with failed prosthesis of the hallux: a case report and literature review.

Three years after replacement of a first metatarsophalangeal joint with a silicone prosthesis, a tennis player developed an enlarged ipsilateral femoral lymph node. The implant was also noted to have failed. Fine needle aspiration of the node revealed a foreign body giant cell reaction to particulates morphologically compatible with silicone elastomer. This finding suggests the potential utility of fine needle aspiration in the evaluation of patient response to foreign materials used in prosthetic devices. The lymphadenopathy also suggests that prosthetic metatarsophalangeal replacement in patients with high demand activities run the risk not only of failure of the prosthesis, but also of central migration of the particulate debris resulting from silicone elastomers.