SpR Trauma and Orthopaedics, 12 Netherwood Grove, Wigan WN3 6NF, UK.
Int Orthop. 2012 Sep;36(9):1865-9. doi: 10.1007/s00264-012-1576-8. Epub 2012 Jun 23.
The short-term results of silastic implant of the first metatarsophalangeal joint (MTPJ) have been successful. However, reservations exist regarding long-term results. The aim of this study was to evaluate long-term outcome of silastic implant prosthesis in treatment of hallus rigidus.
This was a retrospective study, with 108 feet in 83 patients, operated upon between 1988 and 2003. Mean age at operation was 55 years (SD 8.1) with a follow-up period of 8.5 years. Outcome measures included the American Orthopaedic Foot and Ankle Scoring system(AOFAS), passive and active arc of motion. Patients' satisfaction was assessed using the visual analogue scale. All the patients had anteroposterior and oblique views and were assessed for loosening and osteolysis. Pedobarographic studies were performed using the Musgrave Footprint. Complications and revisions were recorded.
The mean total AOFAS score was 77.5 (SD 13.4). Mean active and passive arc of motions were 36.8 degrees (SD 19.13) and 46.82 degrees (SD 17.19), respectively. Patient satisfaction showed mean VAS of 7.73 (SD 2.41). Prostheses were removed in three feet at three, five and seven years respectively because of persistent pain. Radiologically 25 feet (23 %) had osteolysis but were non progressive and didn't correlate with the functional outcome.
We can conclude that silastic implant arthroplasty is an effective procedure in hallux rigidus management with satisfactory functional outcome and high patient satisfaction.
硅橡胶植入第一跖趾关节（MTPJ）的短期效果是成功的。然而，长期效果仍存在争议。本研究旨在评估硅橡胶植入假体治疗僵硬拇趾的长期疗效。
这是一项回顾性研究，纳入了 1988 年至 2003 年间手术的 83 例患者的 108 只脚。手术时的平均年龄为 55 岁（标准差 8.1），随访时间为 8.5 年。评估指标包括美国矫形足踝协会（AOFAS）评分、被动和主动活动度弧、患者满意度（采用视觉模拟评分法）。所有患者均拍摄前后位和斜位片，评估有无松动和骨溶解。采用 Musgrave 足迹法进行足底压力测量。记录并发症和翻修情况。
平均 AOFAS 总评分 77.5（标准差 13.4）。平均主动和被动活动度弧分别为 36.8°（标准差 19.13°）和 46.82°（标准差 17.19°）。患者满意度的平均 VAS 评分为 7.73（标准差 2.41）。因持续性疼痛，分别有 3 只脚在术后 3、5 和 7 年时取出假体。影像学上有 25 只脚（23%）出现骨溶解，但无进展且与功能结果无关。
我们可以得出结论，硅橡胶植入关节成形术是治疗僵硬拇趾的有效方法，可获得满意的功能结果和较高的患者满意度。
