Biomechanical evaluation of pyrocarbon proximal interphalangeal joint arthroplasty: An in-vitro analysis |
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| Affiliation: | 1. Mechanical Engineering Department, University of Aveiro, Portugal;2. Orthopaedics Department, Coimbra University Hospital, Portugal;1. Department of Mechanical Engineering, Brigham Young University, 435 CTB, Provo, UT 84602, United States;2. Department of Statistics, Brigham Young University, 223 TMCB, Provo, UT 84602, United States;3. Neuroscience Center, Brigham Young University, S-192 ESC, Provo, UT 84602, United States;1. University of Aachen Medical Center, Department of Orthopaedic Trauma, Pauwelsstraße 30, 52074 Aachen, Germany;2. University of Aachen Medical Center, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, 52074 Aachen, Germany;3. University of Zurich, Department of Trauma, Rämistrasse 100, 8091 Zürich, Switzerland;1. Department of Orthopaedic Surgery, Affiliated Sixth People''s Hospital, Jiao Tong University, Shanghai, PR China;2. Military Rehabilitation Centre “Aardenburg”, Doorn, The Netherlands;3. Department of Orthopaedic Surgery, Second Affiliated Hospital, Fujian Medical University, Zhongshan North Road 34, Quanzhou 362000, Fujian, PR China;4. Department of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands;5. Department of Joint Surgery & Sports Medicine, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, PR China;6. Department of Rehabilitation Medicine & Physical Therapy, Erasmus University Medical Center, Rotterdam, The Netherlands;7. Orthopaedic Biomechanics Laboratory, Fujian Medical University, Quanzhou, Fujian, PR China |
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| Abstract: | BackgroundPyrocarbon proximal interphalangeal joint arthroplasty provided patients with excellent pain relief and joint motion, however, overall implant complications have been very variable, with some good outcomes at short-medium-term follow-up and some bad outcomes at longer-term follow-up. Implant loosening with migration, dislocation and implant fracture were the main reported clinical complications. The aim of the present work was to test the hypothesis that the magnitude proximal interphalangeal joint cyclic loads in daily hand functions generates stress-strain behaviour which may be associated with a risk of pyrocarbon component loosening in the long-term.MethodsThis study was performed using synthetic proximal and middle phalanges to experimentally predict the cortex strain behaviour and implant stability considering different load conditions for both intact and implanted states. Finite element models were developed to assess the structural behaviour of cancellous-bone and pyrocarbon components, these models were validated against experimentally measured cortex strains.FindingsCortex strains showed a significant increase at dorsal side and reduction at palmar side between intact and implanted states. Cancellous-bone adjacent to the condylar implant base components suffers a two to threefold strain increase, comparing with the intact condition.InterpretationThe use of pyrocarbon implant changes the biomechanical behaviour of the joint phalanges and is associated with a potential risk of support cancellous-bone suffer fatigue failure in mid to long term due to the strain increase for cyclic loads in the range of daily hand activities, this risk is more prominent than the risk of bone resorption due to strain-shielding effect. |
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