Nineteen-year follow-up of the silastic double stemmed hinge prosthesis of the first metatarsophalangeal joint.

The purpose of this retrospective study is to evaluate patient-related outcome and reoperation rate of the Swanson prosthesis in patients with and without grommets. Between 1981 and 1999, 98 Swanson MTP-1 prostheses were implanted in 84 patients (14 bilateral). The average follow-up was 19 years. Patients were asked to fill in the Foot and Ankle Outcome Score (FAOS) questionnaire and were asked if they had undergone reoperations. In addition, medical records where searched. 36 patients (mean age 71 years) returned the questionnaire. All median FAOS sub scores were 100. There were no differences in FAOS sub scores between patients who had a prosthesis with or without grommets, except for FAOS "activities in daily living" which was lower for patients without grommets. Reoperation rate was 4%. The Swanson silastic double stemmed hinge prosthesis showed good to excellent patient-related outcome and reoperation rate at long-term follow-up.