The increasing recognition of medullary lysis, cortical osteophytic proliferation, and fragmentation of implanted silicone polymer implants.

During the past 20 years in the United States more than 2 million hinged, spacing implants, intended to replace degenerated bone and to allow improved motion in cases of hallux rigidus, hallux limitus, rheumatoid arthritis, trauma, and hallux valgus have been implanted in first and lesser metatarsophalangeal joints. In addition, implants made of similar material have been implanted in the fingers, hands, wrists, and elsewhere. Most of these materials have been constructed of silicone rubber or SILASTIC. Adverse effects such as implant fracture, implant particulization, and loss of cortical and intramedullary bone are now being seen with increasing frequency. Salvage surgical procedures are now being developed.