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At least 595 records · Page 33Linked to original sources
PubMed1999

A new prosthesis for the metacarpophalangeal joint. Study of materials and biomechanics.

This report discusses the Daphne prosthesis for the metacarpophalangeal joint on the basis of the mechanical, chemical and biological performance of the materials employed. The Daphne prosthesis is a mobile device. The main body is made of a new generation polymethylmetacrylate, while the hinge is made of AISI 316 L stainless steel. Biocompatibility tests were performed on the materials employed. Systemic toxicity, cytotoxicity and contact tests have given favourable results. Mechanical engineering tests have been used to investigate the performances and reliability of the selected materials. The polymethylmetacrylate used in Daphne behaves in a ductile fashion. No mechanical failures were encountered in fatigue tests after 10 million cycles.

Animals↗
PubMed1989

Alignment of the first metatarsal-phalangeal joint: important criteria for a new joint replacement.

Joint replacement is one of many options for the treatment of the first metatarsophalangeal (MTP) joint. Studies of the geometry of that joint have shown that it consists of two distinct articulations, the metatarsophalangeal and the MT-sesamoidal. Both are important, but the MT-sesamoidal tolerates only small deviations from an ideal alignment. The aim of this study was to investigate the alignment of the first MTP joint of a potential patient population, in order to design an optimal surface replacement. One measurement, the extension angle between the MT and the proximal phalanx was found to be the most important alignment criterion for the successful design of an implant and the necessary instruments. This angle controls the delicate interplay between the metatarsal head and the sesamoids and tolerates only small deviations from the normal range before the chance of sesamoidal subluxation increases significantly. The pre-operative knowledge of this and other alignment criteria is important for the ideal placement of an anatomical implant.

Humans↗
PubMed1991

[Functional characteristics of the upper leg stumps after knee joint disarticulation and prosthesis].

In this article is presented the 20-years experience of surgical preparation and prosthetics of 62 invalids with the femur stumps after knee joint exarticulation at the age of 5-65 years in the clinic of LNIIP. New methods of distal epiphysis transposition with muscle connection preservation instead of diaphysial femur amputations were applied to the patients with the integument defects. There have been broadened and made more accurate indications for knee joint exarticulation as a consequence of a trauma as well as in case of vascular diseases. Prosthetic appliances are made with utilization of modified monocentric knee units, polycentric modules and frame-type full-contact sockets of new design.

Amputation, Surgical↗
PubMed2003

[Arthroplasty of the metacarpophalangeal joint using pyrocarbonate implants].

As early as the 1970s, pyrocarbon became a point of focus in the search for materials for alternative finger replacement. This type of material had already proven its biocompatibility and excellent wear behaviour in its use for artificial heart valves. The first trials with pyrocarbon surface replacement implants for the small finger joints in baboons showed good biocompatibility as well as good functional results. The first patient series confirmed theses results in long-term follow-up. Meanwhile, the surface replacement implants made of pyrocarbon are an interesting alternative to silicon spacers. Further developments for other joints in the hand are under evaluation.

Arthritis, Rheumatoid↗
PubMed1994

In vivo experimental analysis of silicone implants used with titanium grommets.

This study evaluated the titanium grommets recommended to reduce breakage by protecting hinge implants from bone edges. Silastic HP-100 (Dow Corning Wright, Arlington, TN) flexible finger implants (size 5) were used to replace one knee of 10 rabbits, and implants plus titanium grommets were used in another 10. X-ray films were taken monthly; deaths from each group were 1 animal at 2 and 4 months, 2 animals at 6, and 3 each at 12 and 16 months. X-ray films revealed that 4 of 10 implants from each group had fractured. Silicone fractures occurred identically at the proximal stem-hinge junction in both groups, destruction was always most pronounced at the dorsal surface of the proximal stems. The time from surgery to x-ray film evidence of implant fracture without grommets was an average of 9 months and with grommets 13 months. Although grommets delayed x-ray film evidence of fracture onset, after 14 months all implants in both groups of animals fractured. These findings do not support the hypothesis that grommets prevent silicone hinge implant wear or fracture in this experimental model.

Animals↗
PubMed2006

The case against first metatarsal phalangeal joint implant arthroplasty.

This article argues the practice of first metatarsal phalangeal joint (MPJ) implant arthroplasty. Intermediate and long-term studies raise concerns about implant failure and longevity. Other causes for concern are silicone-induced synovitis and lymphadenopathy. This article presents evidence against the practice of first metatarsal phalangeal implant arthroplasty. Intermediate and long-term studies raise concerns about implant failure and longevity. Furthermore, the lack of any significant long-term results and the documented metallic breakdown from two-piece metallic implants make their use in hallux rigidus questionable. Meanwhile, a comparative study shows the superiority of arthrodesis to implant arthroplasty. Also, alternatives to joint-destructive procedures are emerging. These include arthrodiastasis and the osteochondral autograft transfer procedure. This evidence proves that implant arthroplasty is not the best treatment for patients with hallux rigidus or other first-MPJ pathology.

Arthrodesis↗
PubMed2005

Joint replacement in the hallux metatarsophalangeal joint.

Joint replacement of the hallux metatarsophalangeal joint has not enjoyed the same success as hip and knee arthroplasties. Silastic implants have achieved a high patient satisfactory rate but have caused many complications, including silicone synovitis and lymph node inflammation. Metal and polyethylene hemiarthroplasties and total toe replacements seem to be more promising although results are preliminary. Problems with these implants seem to be related to soft tissue instability of the joint; patients who have hallux rigidus have more success than patients who have hallux valgus or rheumatoid arthritis. Severe complications can be treated with removal and synovectomy or arthrodesis, depending on the length and alignment of the foot, as well as the functional demands of the patients. It would be beneficial to have more data on these implants so that improvements can be made in design and patient selection.

Arthroplasty, Replacement↗
PubMed2006

Thumb metacarpophalangeal arthritis: arthroplasty or fusion?

The human thumb assumes 50% of the workload of the human hand, and is therefore the most important digit. As such, the thumb has a propensity for the development of osteoarthritis. Moreover, the thumb is also often diseased, in anywhere from 68% to 80%of patients who have rheumatoid arthritis. Much attention over the years has been given to the carpalmetacarpal joint of the thumb, whereas the metacarpophalangeal (MP) joint of the thumb remains largely unstudied. The purpose of this article is to review the etiology of thumb MP joint arthritis, and discuss the different treatment options of this condition.

Arthritis↗
PubMed2003

A comparison of ex vivo and in vitro Sutter metacarpophalangeal prostheses.

Forty-one Sutter metacarpophalangeal prostheses were implanted into 11 hands of nine patients. Twelve of these prostheses were revised from three patients after a mean period of 42 months. Of the 12 prostheses, 11 showed fracture at the junction of the distal stem and the central hinge region. Two Sutter metacarpophalangeal prostheses were tested on a single station finger simulator and both failed due to fracture at the junction of the hinge and the distal stem.

Arthritis, Rheumatoid↗
PubMed1995

An overview of first metatarsophalangeal joint implant arthroplasty.

The metatarsophalangeal joint of the great toe often requires an arthroplasty to correct joint disease and pain. Today, joint replacement systems are combinations of components manufactured to optimize biological ingrowth, mechanical interlock, press fit, and cementing. Three different types of arthroplasties are available to foot surgeons: the double stem hinged silicone implant, the two-component joint mimicking implant, and a hemi-implant available for the phalanx. No comprehensive studies on very large populations have been conducted to accurately evaluate the beneficial long-term effects of these implants. This review article describes the development of the toe arthroplasty, details the commercially available implants, and addresses the advantages and adverse effects of each implant.

Humans↗