Foreign body reaction after modified silicone rubber arthroplasty of the first carpometacarpal joint.

Twenty patients who had been treated with a silicone rubber trapezial implant for degenerative changes in the first carpometacarpal joint were evaluated radiologically and clinically. After a mean follow up of 4.5 years, 11 of the 20 required reoperation and removal of the prosthesis for persisting pain and weakness. In all hands in which the prosthesis remained radiographs showed bone resorption or carpal bone cysts typical of silicone particle synovitis. In the light of these results we now do not recommend this procedure for the treatment of arthritis of the first carpometacarpal joint.