Lemon B, Pupp G R
Department of Podiatric Surgery, Kern Hospital, Warren, MI 48091, USA.
J Foot Ankle Surg. 1997 Sep-Oct;36(5):341-6; discussion 396-7. doi: 10.1016/s1067-2516(97)80033-6.
A retrospective analysis of the long-term efficacy of total SILASTIC implant arthroplasty performed before 1986 is presented. A total of 50 patients responded to subjective questionnaires regarding pain, function, complications, and overall patient satisfaction. The average age of the patients at the time of surgery was 55.1 years with an average follow-up of 13.4 years (range 10.7 to 16.9 years). Ninety-seven percent of patients reported relief from pain, and the overall success rating was 90.7%. Results were calculated based on a modification of the American Orthopaedic Foot and Ankle Society clinical rating system; the mean rating was 87.3. Attention must be directed at realigning the joint via appropriate osteotomies and soft tissue balancing procedures for increased success. Although radiographic deterioration of the implant was demonstrated in all implants, this deterioration did not correlate with patient satisfaction and should not be the sole criterion for implant removal. We conclude that total implant arthroplasty is a proven procedure for long-term relief of pain in selected patients with degenerative joint disease of the first metatarsophalangeal joint.
本文对1986年前进行的全硅橡胶植入关节成形术的长期疗效进行了回顾性分析。共有50名患者对关于疼痛、功能、并发症及患者总体满意度的主观问卷做出了回应。患者手术时的平均年龄为55.1岁，平均随访时间为13.4年（范围为10.7至16.9年）。97%的患者报告疼痛缓解，总体成功率为90.7%。结果是根据美国矫形足踝协会临床评分系统的修改版计算得出的；平均评分为87.3。必须通过适当的截骨术和软组织平衡手术来调整关节，以提高成功率。尽管所有植入物均显示有影像学上的退变，但这种退变与患者满意度无关，不应作为取出植入物的唯一标准。我们得出结论，全植入关节成形术是一种经证实的可长期缓解第一跖趾关节退行性关节病特定患者疼痛的手术。
