Silicone granulomatous reactions after first metatarsophalangeal hemiarthroplasty.

We reviewed 55 patients (78 feet) who had undergone silicone hemiarthroplasty of the first metatarsophalangeal joint for hallux valgus (40) or hallux rigidus (38). At a mean period of 4.5 years (1 to 11), 56 feet had radiological evidence suggestive of silicone granulomatous disease. The frequency and severity of the changes increased with time from the operation. Histological material from three revisions confirmed the presence of silicone granulomata. We recommend that the operation of silicone hemiarthroplasty for hallux valgus and hallux rigidus be abandoned.