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To the Editor.—
The report by Christie et al apparently correctly notes that silicone elastomer prostheses may produce foreign body reaction in a regional lymph node and synovitis. However, these mild inflammatory reactions have not been placed in proper clinical perspective. The authors correctly state, "Thousands of silicone elastomer... joint prostheses have been inserted," but they do not assert the astonishing rarity of their findings. Based on their own text, the features in their two cases are each quite literally unique. Even the most accommodating statistical evaluation puts the incidence of these minor complications in the miniscule order of thousandths of 1%. Were the incidence of other surgical complications as comparably low.It is quite evident that no crippled arthritic patient should, where appropriate, forego the restoration of function by the insertion of the Swanson silicone elastomer prostheses because of unjustified concern for the correct but unique findings reported.
Nalbandian RM. Complications of Silicone Elastomer Prostheses. JAMA. 1977;238(9):939. doi:10.1001/jama.1977.03280100023014
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