title: Silicone-induced foreign-body reaction after first metatarsophalangeal joint arthroplasty for Jaccoud's arthropathy.
abstract: We report a case of Jaccoud's arthropathy with forefoot plantar callosity. The lesser toe metatarsal heads were resected and Swanson's double-stemmed flexible-hinge implant arthroplasty of the first metatarsophalangeal joint was performed. An osteolytic defect had formed around the implant after 2 years. Surgical revision comprised implant removal and synovectomy. Histology revealed a foreign-body reaction with birefringent material in multinucleated giant cells. Because the capsuloligamentous system is fragile in Jaccoud's arthropathy, we recommend resection arthroplasty or arthrodesis of the first MP joint as an initial operative approach.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences,Mizuhocho, Nagoya, Japan. waguri@med.nagoya-cu.ac.jp
authors.forename: Yuko
authors.initials: Y
authors.lastname: Waguri-Nagaya
authors.forename: T
authors.initials: T
authors.lastname: Yamagami
authors.forename: A
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: M
authors.initials: M
authors.lastname: Nozaki
authors.forename: H
authors.initials: H
authors.lastname: Goto
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
authors.forename: M
authors.initials: M
authors.lastname: Aoyama
authors.forename: T
authors.initials: T
authors.lastname: Tada
authors.forename: T
authors.initials: T
authors.lastname: Otsuka
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid; D001174:Arthrodesis; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D005260:Female; D005549:Foreign-Body Reaction / Q000209:etiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008683:Metatarsophalangeal Joint / Q000002:abnormalities* / Q000601:surgery*; D012828:Silicones / Q000009:adverse effects*
chemical_list: D012828:Silicones