Answer:
Risks include development of silicone synovitis which refers to an inflammatory arthropathy seen in some patients after silicone implant arthroplasty, particularly of the wrist and carpal bones. The pathophysiology appears to relate to microparticulate fragmentation of the implant, particularly in load-bearing implants. Clinically, this presents as an inflammatory synovitis; radiographically, osteopenia and later cyst development are seen. Histologically, the synovitis is characterized by macrophages which have engulfed silicone particles. Particles that are too large to be engulfed tend to become encapsulated and cause minimal reaction. Smaller fragments, of macromolecular size, may induce an immune reaction. Fragments of a size in between that are engulfed by cells seem to most implicated in causing silicone synovitis. Treatment requires removal of the implant and curettage of the reactive bone cysts. Large cysts may require bone grafting.