Surgeons grapple with synovitis, fractures around silicone implants for hand and wrist

Article Abstract:

Approximately 2,000 wrist implants and 7,000 hand and finger implants are inserted each year, and many doctors are concerned about the consequences of their widespread use. Many studies of hand and wrist implants have found that silicone particles migrate into surrounding tissue and induce an immune response that can destroy bone. Destruction of bone can lead to fractures. In many cases, the damage caused by the implant can surpass the original joint disease. Many patients require repeat surgery. Complications from wrist implants became more common when their manufacturer, Dow Corning Wright, introduced wear-resistant implants in 1977. One doctor switched back to the original-grade implants in 1985 because of the high incidence of complications. One scientist says there is more evidence confirming the destructive nature of wrist implants than there is on breast implants, but an FDA spokesperson says the agency is not planning to investigate wrist implants.

Artificial joints, Joint prostheses

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Less maligned, but cut from the same cloth, other silicone implants also have adverse effects

Article Abstract:

The controversy over the health aspects of silicone breast implants has alerted researchers to possible side effects of other polymers used in medicine. These range from artificial lenses in the eye to artificial joints, pacemakers and catheters. Millions of people have received silicone implants, but the long-term safety of the devices has never been studied. Doctors knew that the body produces a fibrous capsule around the implant, and they thought this capsule would protect the body. But researchers have found silicone particles in the tissue surrounding the implant, and even in lymph nodes near the implant. The body produces an immune response to the silicone particles, which could damage joints. Many surgeons say the body produces an immune response to any foreign object placed in the body, but the response is usually benign. If use of these materials was restricted, orthopedic surgery would cease to exist.

Prostheses and implants, Prosthesis, Polymers in medicine, Biocompatible polymers

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Antibodies to silicone detected in patients with severe inflammatory reactions

Article Abstract:

A study of 300 patients who had ventriculoperitoneal shunts found that two patients who had a severe inflammatory reaction to the shunts had antibodies to silicone in their blood. The antibody levels were much higher than in a group of patients who did not have a reaction to the shunt, as well as in a group of healthy individuals who did not have a shunt. The study was reported in the Aug 29, 1992 issue of The Lancet. The same researchers found that half of the 79 women with breast implants they studied also had antibodies to silicone in their blood. This has been confirmed by at least one other study. However, the antibodies may not necessarily cause the inflammatory response. It is more likely that the response is a result of macrophages, immune cells that secrete inflammatory chemicals. It may be time to re-evaluate the assumption that material made from silicone does not cause an immune response.

Physiological aspects, Breast implants, Peritoneovenous shunts, Peritoneovenous shunt

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