Long-term clinical results with Swanson silastic replacements of the basal joint of the big toe 10 to 16 years after surgery are presented. Among the 60 clinically and radiologically re-examined joints there was a striking discrepancy between subjective satisfaction and objective radiologic findings. In some cases pronounced wear of the metatarsal capitulum was seen, with synovitis of varying degrees of clinical severity. The continued use of silicone implants to replace the basal joint of the big toe can only be recommended if radiologic follow-up examinations are performed more frequently. The results of the ten-year study presented here must be taken into account in patient counselling concerning surgery.
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