A long-term follow-up was evaluated on silastic implant arthroplasty performed on five patients (seven feet) for pathology of the metatarsophalangeal joint of the hallux. Four patients (five feet) displayed an inflammatory reaction in the immediate postoperative period with considerable swelling about the operative site. Subsequently, these patients developed either delayed wound healing of mild skin necrosis with secondary superficial infection. Three patients (five feet) ultimately developed implant failure via fracture of the prosthesis and/or erosion through the articulating surface of the prosthesis. All patients had late roentgenographic findings of resorption of bone around the implants. These complications necessitated removal of implants in three patients (five feet). Implant removal was recommended but refused in two patients (two feet).