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At least 685 records · Page 38Linked to original sources
PubMed1993

Stress analysis of a flexible one-piece type first metatarsophalangeal joint implant.

Two-dimensional finite element analysis was used to obtain the magnitude and distribution of the stresses in models of two different designs of a flexible one-piece double-stemmed first metatarsophalangeal joint implant. The loading and constraint conditions have been reported by previous researchers to occur in vivo at the joint during the push-off phase of the normal walking cycle. Based on the results obtained, the authors recommend the direction that future studies in this area should take.

Humans↗
PubMed1979

[The anatomical GT sledge endoprosthesis Lübeck (author's transl)].

In case of complete or partial destruction of articular surfaces of the knee joint where the ligamentous apparatus is present but probably insufficient, alloplastic substitution of the articular surfaces is indicated. To achieve mobility as ideally as possible, it will be necessary to shape the endoprosthetic parts in such a manner that the healthy knee joint is imitated as closely as ever possible. The anatomical GT sledge endoprosthesis Lübeck (Grundei--Thomas) was conceived with this view in mind. To preserve the knee-joint as a functional unit, all of its compartments were taken into consideration, in particular also the articulatio plana, or arthrodial joint. To perform implantation of these endoprosthetic parts without improvisation, the implantates must be prepared in accordance with surgical patterns. The high functional demands made on the knee joint can only be met by completely abandoning the simplified schematic shapes and by producing articular surface substitutes imitating the normal anatomic joints.

Humans↗
PubMed1997

Use of grommets for flexible implant resection arthroplasty of the metacarpophalangeal joint.

In 1987, after 11 years of research, press fit titanium circumferential grommets were introduced for arthroplasty of the metacarpophalangeal joint to protect the flexible hinge implant midsection from sharp bony edges and shearing forces that can initiate implant abrasions and tears leading to implant fracture and formation of silicone wear particles. The effectiveness of the titanium circumferential grommets was assessed by comparing the results of 170 metacarpophalangeal joint implant (high performance) arthroplasties performed with (139 joints) and without (31 joints) grommets in 38 patients presenting an average 5.8 years followup. Both groups obtained pain relief, functional motion, stability, and correction of deformity. There was no evidence of particulate synovitis or infection. There were four implant fractures (12.9%) in the nongrommet group, and one (0.7%), because of implant rotation, in the grommet group. Although favorable bone remodeling was observed in both groups, the grommet group showed greater bone preservation at the metaphyseal and midshaft levels and increased intramedullary bone production around the implant stems. The results depend on appropriate surgical staging, meticulous operative and postoperative techniques, severity and progression of disease, and implant durability. The circumferential grommets safely and effectively protect the implant to bone interface to further the durability of implant arthroplasty of the metacarpophalangeal joint.

Arthritis, Rheumatoid↗
PubMed1983

The geriatric bunion: correction of metatarsus primus varus and hallux valgus with the Swanson total joint implant.

The authors have evaluated the long-term results of the Keller/Mayo bunionectomy with replacement of the first metatarsophalangeal joint with a Silastic double-stemmed implant (Swanson design). Examination of 50 preoperative and postoperative radiographs revealed a decrease in the hallux abductus angle of 21.46 +/- 2.66 degrees, and the intermetatarsal angle of 6.40 +/- 0.67 degrees; both of these figures have a statistically significant probability value of 0.05 attached. The mean patient age at time of surgery was 61.31 years; the mean follow-up time was 5.01 months. A literature review of implant arthroplasty for correction of hallux abducto valgus deformity is also presented.

Aged↗
PubMed1986

Trapeziometacarpal total joint replacement using the Steffee prosthesis.

The first forty-five Steffee trapeziometacarpal total joint replacements that were used to treat severe trapeziometacarpal arthritis in thirty-eight patients were analyzed retrospectively. The length of follow-up ranged from two through six and one-half years. Forty-two of the arthroplasties resulted in relief of pain, and the restoration of strength and motion was highly satisfactory. Although radiographs showed a high incidence of asymptomatic radiolucent lines at the bone-cement interface of the trapezial component, only three patients had symptomatic loosening. We concluded that trapeziometacarpal total joint replacement can provide good relief of pain and restore function of the thumb to patients with severe trapeziometacarpal arthritis, although further study is necessary to assess the long-term results of the procedure.

Arthritis, Rheumatoid↗
PubMed1993

Simulation and animation of musculoskeletal joint system.

This paper describes the development of computer-based software for three-dimensional geometric data base of the human musculoskeletal system. Using a computer graphics workstation, a user of the software will interactively display detailed information about the muscles, tendons, ligaments, bone, and joint anatomy. This software will enable a wide range of health care workers to visualize complex physiological data. In addition to geometric and visual realism, this software will include kinematic relationships which allow the calculation and display of the motion and forces of the joints, muscles, and tendons. This will permit a user to interactively move joints or tendons and display the resulting motion of the surrounding tissues, as well as internal reactive forces and joint pressure distribution. A two-dimensional version of this software is currently being used for knee and hip osteotomy preoperative planning, total joint replacement prosthesis design and dimensional selection, and osteochondral allograft sizing and reconstruction using radiographic data.

Computer Simulation↗
PubMed2005

[Early results of proximal interphalangeal joint replacement with pyrolytic carbon prosthesis (Ascension) in idiopathic and post-traumatic arthritis].

Surgical treatment of painful idiopathic and post-traumatic arthritis with joint replacement of the proximal interphalangeal joint has become increasingly important. Due to shortcomings of former constrained and partially constrained prostheses with regard to abrasion and durability we have been using an unconstrained prosthesis since April 2002. This model is an almost abrasion free, biocompatible 2-component prosthesis. The surface is shaped like the condyles and the position is secured in a press-fit technique. During October 2004 we reviewed the results of 20 out of 29 patients with idiopathic or post-traumatic arthritis who had been treated with a pyrolytic carbon proximal interphalangeal joint prosthesis from April 2002 to April 2004 retrospectively. Clinical, subjective and radiological parameters were studied. On follow-up after 0.5 to 2.5 years the patients were satisfied with the pain relief. The range of motion varied. However, with an average ROM of 50 degree it was equivalent to the results in literature. Signs of periprosthetic cysts, osteophytes and loosening of the proximal as well as of the distal component could be seen in the radiograms of some patients. There was no correlation between these radiological observations and range of motion, pain or grip strength. In three cases the joint prosthesis had to be converted to an arthrodesis of the proximal interphalangeal joint. Bearing in mind the correct indications (intact collateral ligaments, stable bone stock and sufficient extensor and flexor tendons), pyrocarbon prosthesis are a treatment option for idiopathic and posttraumatic arthritis preserving motion and reducing pain. Radiological results seem to indicate an absence of osteointegration and tension forces at the prosthesis/bone interface. Further investigation will be necessary to improve surface and design to increase radiological results in long-term follow-up. Additional surveys are required to improve indications, surgical approach and intraoperative control of correct component positioning.

Adult↗