Total joint replacement in bunion surgery.

A preliminary report is given for total joint replacement arthroplasty utilizing a silicone-polyester prosthesis, in selected cases of destroyed metatarsophalangeal joints of the great toe. Fifty-three prostheses were implanted over a period from March 1971 to March 1977, with a minimum follow-up of one year. Overall results were good from the standpoint of pain relief and cosmetic correction, in severely destroyed and deformed joints. The essential aspects for successful prosthetic arthroplasty include proper seating of the prosthesis and complete realignment of the first ray, paralleling the adjacent metatarsals. On the basis of these preliminary results, it is concluded that there is a place for total joint prosthetic replacement in the surgical reconstruction of the painful, destroyed metatarsophalangeal joint of the great toe.