The Use of a Grommet Bone Liner for Flexible Hinge Implant Arthroplasty of the Great Toe

Swanson, Alfred B.; Swanson, G de Groot; Maupin, B; Shi, S G; Peters, J.; Alander, Dirk H.; Cestari, Valeria A.

doi:10.1177/107110079101200304

Cited by 57 publications

(18 citation statements)

References 6 publications

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“…5 In a study using implants with or without titanium grommets, results were excellent in 90 feet (66 had RA) after a mean of 29 months. 6,8 There was no evidence of silicone synovitis, bone resorption, or implant fracture; only 2 implants rotated and required revision. 6,8 In a case report examining the bone/implant interfaces, silicone particles within the fibrous tissue, and a tear and severe scuffing of the implant surface were detected in the joint without grommets (but not in the joint with grommets.…”

Section: Discussionmentioning

confidence: 99%

“…6,8 There was no evidence of silicone synovitis, bone resorption, or implant fracture; only 2 implants rotated and required revision. 6,8 In a case report examining the bone/implant interfaces, silicone particles within the fibrous tissue, and a tear and severe scuffing of the implant surface were detected in the joint without grommets (but not in the joint with grommets. 16 Grommets may improve implant durability and prevent particulate synovitis.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Thus, Swanson introduced the High Performance Silicone Elastomer (Dow Corning Wright, Arlington [TN], USA), with press-fit titanium grommets to shield the implants. [6][7][8][9] In the present study, no evidence of silicone synovitis or mechanical failure was noted. The sclerotic lines were probably a bony response to the implant.…”

Section: Discussionmentioning

confidence: 99%

“…3,5 However, sharp bony edges and shearing forces may tear the implant midsection and lead to implant failures. 6,7 Thus, titanium grommets are added to the flexible hinge silicone implants. [6][7][8][9] We reviewed outcomes of 37 patients who underwent arthroplasty of the first metatarsophalangeal joint using flexible hinge silicone implants with or without titanium grommets.…”

Section: Introductionmentioning

confidence: 99%

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Flexible Hinge Silicone Implant with or without Titanium Grommets for Arthroplasty of the First Metatarsophalangeal Joint

Kanzaki

Nishiyama

Fujishiro

et al. 2014

J Orthop Surg (Hong Kong)

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Purpose. To review outcomes of 37 patients who underwent arthroplasty of the first metatarsophalangeal joint using flexible hinge silicone implants with or without titanium grommets. Methods. 36 women and one man (63 feet) underwent arthroplasty of the first metatarsophalangeal joint for rheumatoid arthritis (RA) using Swanson flexible hinge silicone toe implants with or without titanium grommets. 20 women (35 feet) aged 31 to 72 (mean, 52) years with Steinbrocker grade II (n=4), grade III (n=6), and grade IV (n=10) RA of the feet were treated with the implant without grommets, whereas 16 women and one man (28 feet) aged 48 to 73 (mean, 60) years with Steinbrocker grade III (n=4) and grade IV (n=13) RA of the feet were treated with the implant with grommets. Pain levels were self-rated. Degenerative changes and the presence of osteophytes or deformity were recorded, as were breakage or deformation of the implants, radiolucencies around the implant, implant loosening, silicone-induced synovitis, and Address correspondence and reprint requests to: Dr Noriyuki Kanzaki, Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. Email: kanzaki@med.kobe-u.ac.jp Surgery 2014;22(1):42-5 sclerosis around the implant. Results. All patients reported pain relief from severe to mild or moderate. Respectively for the feet with and without grommets, the rates of implant deformation were 25% and 63% (p=0.031), whereas the rates of moderate-to-severe radiolucencies (>2 mm) were 4% and 34% (p=0.004). Sclerosis developed around the implant in all feet. Conclusion. Titanium grommets appear to protect the implant and improve clinical outcomes. Journal of Orthopaedic

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Flexible Hinge Silicone Implant with or without Titanium Grommets for Arthroplasty of the First Metatarsophalangeal Joint

Kanzaki

Nishiyama

Fujishiro

et al. 2014

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

show abstract

“…Titanium metal grommets were introduced in 1987 for MCP joint arthroplasty and theoretically protect the silicone implant from fracture and fragmentation [15,16,18,[20][21][22]. We found two reports of particulate metal debris associated with silicone implants with grommets leading to a robust tissue reaction [9,25].…”

Section: Introductionmentioning

confidence: 99%

Metallosis Following Silicone Metacarpophalangeal Joint Arthroplasties with Grommets: Case Report

Choudhry

Wilson

Stern

2012

Hand (New York, N,Y.)

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Wear of medical grade silicone rubber against titanium and ultrahigh molecular weight polyethylene

Pylios

Shepherd

2007

J Biomed Mater Res

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The replacement of arthritic small joints, such as the fingers and wrist, has typically involved the use of one-piece silicone rubber implants. Newer designs have involved the silicone moving against either a titanium or ultrahigh molecular weight polyethylene (UHMWPE) component. The aim of this study was to investigate the wear of medical grade silicone rubber against titanium and UHMWPE. A pin-on-disc apparatus was used to slide a titanium and UHMWPE pin against a silicone disc, in the presence of either a Ringer's solution or bovine serum lubricant. Testing was undertaken at a sliding speed of 0.079 m/s and was continued for 10 km. Wear factors for titanium against silicone were 40.0 x 10(-6) mm(3)/N m and 66.5 x 10(-6) mm(3)/N m for bovine serum and Ringer's solution, respectively. The wear factors for UHMWPE against silicone were higher with values of 84.4 x 10(-6) mm(3)/N m and 88.3 x 10(-6) mm(3)/N m for bovine serum and Ringer's solution, respectively. The results of this study will be useful in future designs of finger and wrist implants that combine silicone rubber with either titanium or UHMWPE.

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The Use of a Grommet Bone Liner for Flexible Hinge Implant Arthroplasty of the Great Toe

Cited by 57 publications

References 6 publications

Flexible Hinge Silicone Implant with or without Titanium Grommets for Arthroplasty of the First Metatarsophalangeal Joint

Flexible Hinge Silicone Implant with or without Titanium Grommets for Arthroplasty of the First Metatarsophalangeal Joint

Metallosis Following Silicone Metacarpophalangeal Joint Arthroplasties with Grommets: Case Report

Wear of medical grade silicone rubber against titanium and ultrahigh molecular weight polyethylene

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