• 1

    Anderson MR, Ho BS, Baumhauer JF: Current concepts review: hallux rigidus. Foot Ankle Orthop 3: 247301141876446, 2018.

  • 2

    Ashford RL, Tollafield D, Vogiatzoglou F, et al: A retrospective analysis of Swanson Silastic double-stemmed great toe implants with titanium grommets following podiatric surgery for arthritic joint disease. Foot 10: 69, 2000.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Barouk LS, Barouk P: Joint-preserving surgery in rheumatoid forefoot: preliminary study with more-than-two-year follow-up. Foot Ankle Clin 12: 435, 2007.

  • 4

    Berlet GC, Hyer CF, Lee TH, et al: Interpositional arthroplasty of the first MTP joint using a regenerative tissue matrix for the treatment of advanced hallux rigidus. Foot Ankle Int 29: 10, 2008.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Gross CE, Hsu AR, Lin J, et al: Revision MTP arthrodesis for failed MTP arthroplasty. Foot Ankle Spec 6: 471, 2013.

  • 6

    Stone OD, Ray B, Thomsen CE, et al: Long-term follow-up of arthrodesis vs total joint arthroplasty for hallux rigidus. Foot Ankle Int 38: 375, 2016.

  • 7

    Zelent ME, Neese DJ: Osteochondral autograft transfer of the 1st metatarsal head: a case report. J Foot Ankle Surg 44: 406, 2006.

Failed Bilateral Total Silastic First Metatarsophalangeal Joint Implant Reconstructed with Osteochondral Allograft Implantation

Thomas S. Poynter Orthopedics Division of Podiatric Medicine and Surgery, University of Louisville, Louisville, KY.

Search for other papers by Thomas S. Poynter in
Current site
Google Scholar
PubMed
Close
 DPM
and
Timothy Ford Orthopedics Division of Podiatric Medicine and Surgery, University of Louisville, Louisville, KY.

Search for other papers by Timothy Ford in
Current site
Google Scholar
PubMed
Close
 DPM

First metatarsophalangeal joint (MPJ) arthritis is a very common form of arthritis seen in the foot. Some signs and symptoms include pain, swelling, decreased passive and active range of motion, difficulty with shoe gear, and so forth. Surgically, options for alleviating symptomatic hallux limitus and arthritis fall into two broad categories: joint sparing and joint sacrificing. In this case study, we present a patient with a bilateral failed total silastic implant of the first MPJ and our proposed revision using an osteochondral bone allograft to fill the deficit left behind from silastic implant removal. The ability for immediate weightbearing and to perform this procedure bilaterally is an advantage to this surgical treatment option compared with other described revision techniques. Postoperatively, the patient has adequate range of motion and no pain when ambulatory. We believe this osteochondral allograft implant may be a viable option for revision first MPJ arthroplasty in select patient populations.

Corresponding author: Thomas S Poynter, DPM, Orthopedics Division of Podiatric Medicine and Surgery, University of Louisville, 142 Chenowith Ln, Louisville, KY 40207. (E-mail: tspoyn01@louisville.edu)
Save