THE RESULTS OF TREATMENT OF SYNOVITIS OF THE WRIST INDUCED BY PARTICLES OF SILICONE DEBRIS

Synovitis of the wrist induced by particles of silicone debris is a de structive inflammatory process, Many silicone-rubber carpal implants r emain in place, and there are few reports regarding the treatment of t his condition, The purpose of the present study was to examine the res ults of treatment of synovitis induced by particles of silicone debris , Twenty-eight patients were identified, with use of computerized inde xing, as having been evaluated for silicone-induced synovitis between 1972 and 1992, Seventeen of the twenty-eight patients were included in the study At the time of the latest follow-up, twelve of the seventee n patients had pain, thirteen of the fourteen patients for whom radiog raphs were available had evidence of osteolysis typical of that associ ated with debris-induced synovitis, and eight of the seventeen patient s reported difficulty with activities of daily living because of probl ems with the wrist, Seven patients had been treated non-operatively, a nd ten had been treated operatively. With the small number of patients available for study, we could not detect a significant difference bet ween the two groups with respect to pain, perceived limitation of moti on, difficulty with activities of daily living, grip strength, or the total range of motion of the wrist, There was no significant differenc e between the two groups with regard to the age at the time of the ini tial procedure, the time to the diagnosis of the synovitis, and the du ration of follow-up after treatment, There was no clear advantage to r emoval of the implant and debridement with or without arthrodesis of t he wrist or other reconstructive procedures, We recommend caution when a reconstructive or salvage procedure in the wrist is selected for a patient who has synovitis induced by particles of silicone debris.