Lemon R A, Engber W D, McBeath A A
Foot Ankle. 1984 Mar-Apr;4(5):262-6. doi: 10.1177/107110078400400507.
Seven cases of painful reactive synovitis following great toe Silastic hemiarthroplasty have been observed. All cases were treated successfully with synovectomy and removal of the implant. Microscopic examination of the synovium uniformly demonstrated a chronic foreign-body giant-cell reaction with intracellular and extracellular silicone elastomer particles. Gross examination of the implants showed varying degrees of erosion of the articulating surface. Abrasion of a Silastic implant creates free-floating silicone elastomer particles that can precipitate a reactive synovitis. The authors believe an irregular, degenerated first metatarsal head is a contraindication to an interpositional Silastic hemiarthroplasty.
已观察到7例拇趾硅橡胶半关节置换术后发生疼痛性反应性滑膜炎的病例。所有病例均通过滑膜切除术和取出植入物成功治愈。滑膜的显微镜检查一致显示为慢性异物巨细胞反应，伴有细胞内和细胞外硅橡胶弹性体颗粒。植入物的大体检查显示关节表面有不同程度的侵蚀。硅橡胶植入物的磨损会产生游离的硅橡胶弹性体颗粒，可引发反应性滑膜炎。作者认为，不规则、退变的第一跖骨头是硅橡胶间置半关节置换术的禁忌证。
