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August 29, 1977

Complications of Silicone Elastomer Prostheses

JAMA. 1977;238(9):939. doi:10.1001/jama.1977.03280100023013

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To the Editor.—  I am writing in response to the article "Silicone Lymphadenopathy and Synovitis" by Christie, Weinberger, and Dietrich (237:1463, 1977). The authors described a socalled "detritic synovitis" associated with silicone particles around finger joint implants and also two cases of single lymph node involvement with what appeared to be silicone particles within macrophage cells. We do not disagree that it is possible to have detritic material enter the lymph node filtering system and be deposited in lymph nodes. However, we have never seen this in more than 2,000 of our patients, nor has it been reported to us in our more than 300 field clinics around the world except in one case, which was previously reported. We also are in the process of publishing a paper of the pathological examination of two animals that had implants in them for more than ten years without any evidence of lymph