Case 1. 1st MTPJ Silastic Replacement: Evidence for Functional Outcome

Description

In this presentation, Tim Clough discusses the use of silastic joint replacements versus traditional joint fusions for managing hallux rigidus, a condition causing stiffness and pain in the big toe. Clough highlights the ideal candidates for silastic replacement, emphasizing women over 55 who desire joint flexibility and an active lifestyle. He contrasts this with contraindications, notably for men and younger patients, where traditional fusion methods might be preferred.



Clough critiques historical concerns regarding silastic implants, suggesting that past studies focused on outdated designs and may not reflect contemporary practices with double-stem implants, which show promising outcomes. Recent literature supports the effectiveness of the newer silastic implants, with high patient satisfaction and survival rates comparable to major joint replacements.



He compares silastic to alternative treatments like Cartiva, noting higher failure rates and dissatisfaction with Cartiva. Clough concludes by promoting silastic for its pain relief, quick recovery, and movement preservation, while suggesting that if patients prefer less effective or painful options, they might opt for Cartiva or fusion.

DOI: 10.1302/3114-210097

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