scholarly journals A biomechanical study of the effects of simulated ulnar deviation on silicone finger joint implant failure

2016 ◽  
Vol 41 (9) ◽  
pp. 944-947 ◽  
Author(s):  
P. Drayton ◽  
B. W. Morgan ◽  
M. C. Davies ◽  
G. E. B. Giddins ◽  
A. W. Miles
Keyword(s):  
Metacarpophalangeal Joint ◽  
Biomechanical Study ◽  
Implant Failure ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Ringer’S Solution ◽  
Joint Implant ◽  
Cause Of Failure ◽  
Implant Wear

Silicone finger arthroplasties are used widely, especially for metacarpophalangeal joint replacement in patients with inflammatory arthritis. Implant failure is well recognized. The rates of failure in vivo differ substantially from experience in vivo. One cause of failure is felt to be post-operative ulnar deviation. The aim of our study was to test the effect of ulnar deviation testing on silicone finger implants. We tested 12 implants in three groups of four implants. The implants were submerged in a bath of Ringer’s solution at 370 °C throughout the experiment and tested in a rig held in 0°, 10° and 20° deviation. The rig was cycled at 1.5 Hz from 0°–90°. The implants were inspected every 500,000 cycles until a total of 4 million cycles. There was consistently increased wear and supination plastic deformity in going from 0°–20° deviation. This study confirms the adverse effects of ulnar deviation on silicone finger implant wear. It is likely that this combines with lateral pinch forces and sharp bone edges to cause catastrophic silicone implant failure. Level of evidence: III

In-vivo three-dimensional measurement of distal radioulnar joint translation in normal and clinically unstable populations

2016 ◽  
Vol 41 (5) ◽  
pp. 521-526 ◽  
Author(s):  
G. T. Pickering ◽  
H. Nagata ◽  
G. E. B. Giddins
Keyword(s):  
Joint Instability ◽  
Distal Radioulnar Joint ◽  
Joint Stability ◽  
Forearm Rotation ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Radioulnar Joint ◽  
Normal Ranges ◽  
Clinical Instability

Assessment of distal radioulnar joint instability is clinically difficult and subjective. The distal radioulnar joint is postulated to ‘tighten’ in ulnar/radial deviation and pronation/supination. Using a rig, we measured mean distal radioulnar joint translation in neutral forearm rotation and neutral wrist radial and ulnar deviation, as well as extremes of wrist radial and ulnar deviation and forearm rotation. We tested the rig on ten cadaver forearms to validate the measurements we made. We tested 50 normal adults and 50 patients with clinical distal radioulnar joint instability. Distal radioulnar joint stability in men and women and on contralateral sides were comparable. Distal radioulnar joint translation decreased significantly with wrist radial and ulnar deviation and forearm pronation and supination, matching clinical practice and further validating the rig. The data in normal patients is comparable with previous computed tomography-based studies. Translation in all positions was statistically increased within the clinical instability group and did not cross-over with the normal ranges. Distal radioulnar joint translation is a physically measurable phenomenon. Our device appears to be a valid test of distal radioulnar joint translation, establishing normal data in vivo. Level of Evidence: III

A volar approach to on-top plasty for correction of radial polydactyly: a case series of 21 patients

2021 ◽  
pp. 175319342098185
Author(s):  
Xia Fang ◽  
Ping-tak Chan ◽  
Shengbo Zhou ◽  
Xinyi Dai ◽  
Ruiji Guo ◽  
...  
Keyword(s):  
Case Series ◽  
Functional Results ◽  
Metacarpophalangeal Joint ◽  
Contralateral Side ◽  
Average Score ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Volar Approach ◽  
Flexion Extension ◽  
Aesthetic Results

Correction of unequal radial polydactyly in which neither thumb duplicates possess both well-developed proximal and distal components, remains challenging. Current techniques using on-top plasty techniques require circumferential incisions, often resulting in postoperative swelling and dorsal scars. We described our experience using a volar approach to achieve better aesthetic and functional results. Twenty-one patients underwent this surgery between 2008 and 2018, with a mean follow-up of 5.1 years. The mean flexion–extension arc for the metacarpophalangeal joint was 75° and that of the interphalangeal joint was 43°. Mean percentage of key, tripod and tip pinch strength were 77%, 79% and 77%, respectively, when compared with the contralateral side. The Vancouver Scar Scale showed an average score of 1.2. We conclude from our study that the volar approach to on-top plasty is a good technique for the correction of unequal radial polydactyly, with good functional and aesthetic results. Level of evidence: IV

Soft tissue abnormalities in Wassel Type VI radial polydactyly: a detailed anatomical study

2021 ◽  
Vol 46 (4) ◽  
pp. 352-359
Author(s):  
Susumu Saito ◽  
Itaru Tsuge ◽  
Hiroki Yamanaka ◽  
Naoki Morimoto
Keyword(s):  
Soft Tissue ◽  
Three Dimensional ◽  
Anatomical Study ◽  
Metacarpophalangeal Joint ◽  
Abductor Pollicis Brevis ◽  
Level Of Evidence ◽  
Thenar Muscle ◽  
Pulley System ◽  
Radial Deviation ◽  
Tissue Abnormalities

Wassel VI radial polydactyly is associated with metacarpal adduction and radial deviation of the metacarpophalangeal joint of the ulnar duplicate. The soft tissue abnormalities responsible for these deformities were characterized using preoperative multi-planar three-dimensional ultrasound and intraoperative observation in four patients. In all patients, the abductor pollicis brevis and superficial head of the flexor pollicis brevis inserted into the radial first metacarpal, whereas the adductor pollicis and deep head of the flexor pollicis brevis inserted into the ulnar thumb. Aberrant location of the flexor pollicis longus and absence of the A1 pulley system was associated with severe radial deviation. An additional superficial thenar muscle along the ulnar metacarpal was associated with minimal metacarpal adduction. Uneven forces on the ulnar duplicate could be associated with these characteristic deformities and joint instability. Knowledge of these abnormalities allows better planning of surgery and further insight into this rare radial polydactyly configuration. Level of evidence: II

scholarly journals Current status of wet lab and cadaveric simulation in urological training: A systematic review

2020 ◽  
Vol 14 (11) ◽  
Author(s):  
Ahmed Al-Jabir ◽  
Abdullatif Aydin ◽  
Hussain Al-Jabir ◽  
M. Shamim Khan ◽  
Prokar Dasgupta ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
In Vivo Studies ◽  
Current Status ◽  
Level Of Evidence ◽  
Cadaveric Simulation ◽  
Randomized Controlled Studies ◽  
Wet Lab ◽  
Urological Training

Introduction: We undertook a systematic review of the use of wet lab (animal and cadaveric) simulation models in urological training, with an aim to establishing a level of evidence (LoE) for studies and level of recommendation (LoR) for models, as well as evaluating types of validation. Methods: Medline, EMBASE, and Cochrane databases were searched for English-language studies using search terms including a combination of surgery, surgical training, and medical education. These results were combined with wet lab, animal model, cadaveric, and in-vivo. Studies were then assigned a LoE and LoR if appropriate as per the education-modified Oxford Centre for Evidence-Based Medicine classification. Results: A total of 43 articles met the inclusion criteria. There was a mean of 23.1 (±19.2) participants per study with a median of 20. Overall, the studies were largely of low quality, with 90.7% of studies being lower than 2a LoE (n=26 for LoE 2b and n=13 for LoE 3). The majority (72.1%, n=31) of studies were in animal models and 27.9% (n=12) were in cadaveric models. Conclusions: Simulation in urological education is becoming more prevalent in the literature, however, there is a focus on animal rather than cadaveric simulation, possibly due to cost and ethical considerations. Studies are also predominately of a low LoE; more higher LoEs, especially randomized controlled studies, are needed.

Load Response of the Tarsal Bones in Patients with Flatfoot Deformity: In Vivo 3D Study

2011 ◽  
Vol 32 (11) ◽  
pp. 1017-1022 ◽  
Author(s):  
Masamitsu Kido ◽  
Kazuya Ikoma ◽  
Kan Imai ◽  
Masahiro Maki ◽  
Ryota Takatori ◽  
...  
Keyword(s):  
Load Condition ◽  
Clinical Analysis ◽  
Biomechanical Analysis ◽  
Talonavicular Joint ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Talocalcaneal Joint ◽  
Load Response ◽  
Tarsal Bones

Background: The objective of this study was to evaluate the bone rotation of each joint in the hindfoot and compare the load response in healthy feet with that in flatfeet by analyzing the reconstructive three-dimensional (3D) CT image data during weightbearing. Methods: CT scans of 21 healthy feet and 21 feet with flatfoot deformity were taken in non-load condition followed by full-body weightbearing load condition. The images of the hindfoot bones were reconstructed into 3D models. The volume merge method in three planes was used to calculate the position of the talus relative to the tibia in the tibiotalar joint, the navicular relative to the talus in talonavicular joint, and the calcaneus relative to the talus in the talocalcaneal joint. Results: The talar position difference to the load response relative to the tibia in the tibiotalar joint in a flatfoot was 1.7 degrees more plantarflexed in comparison to that in a healthy foot ( p = 0.031). The navicular position difference to the load response relative to the talus in the talonavicular joint was 2.3 degrees more everted ( p = 0.0034). The calcaneal position difference to the load response relative to the talus in the talocalcaneal joint was 1.1 degrees more dorsiflexed ( p = 0.0060) and 1.7 degrees more everted ( p = 0.0018). Conclusion: Referring to previous cadaver study, regarding not only the cadaveric foot, but also the live foot, joint instability occurred in the hindfoot with load in patients with flatfoot. Clinical Relevance: The method used in this study might be applied to clinical analysis of foot diseases such as the staging of flatfoot and to biomechanical analysis to evaluate the effects of foot surgery in the future. Level of Evidence: III

scholarly journals Estimation of the Abduction/Adduction Movement of the Metacarpophalangeal Joint of the Thumb

2021 ◽  
Vol 11 (7) ◽  
pp. 3158
Author(s):  
Néstor J. Jarque-Bou ◽  
Margarita Vergara ◽  
Joaquín L. Sancho-Bru
Keyword(s):  
3D Modeling ◽  
Daily Living ◽  
Degrees Of Freedom ◽  
Estimation Error ◽  
Metacarpophalangeal Joint ◽  
Joint Movement ◽  
Carpometacarpal Joint ◽  
Small Space ◽  
Joint Motions

Thumb opposition is essential for grasping, and involves the flexion and abduction of the carpometacarpal and metacarpophalangeal joints of the thumb. The high number of degrees of freedom of the thumb in a fairly small space makes the in vivo recording of its kinematics a challenging task. For this reason, along with the very limited independence of the abduction movement of the metacarpophalangeal joint, many devices do not implement sensors to measure such movement, which may lead to important implications in terms of the accuracy of thumb models. The aims of this work are to examine the correlation between thumb joints and to obtain an equation that allows thumb metacarpophalangeal abduction/adduction movement to be estimated from the other joint motions of the thumb, during the commonest grasps used during activities of daily living and in free movement. The correlation analysis shows that metacarpophalangeal abduction/adduction movement can be expressed mainly from carpometacarpal joint movements. The model thus obtained presents a low estimation error (6.29°), with no significant differences between grasps. The results could benefit most fields that do not typically include this joint movement, such as virtual reality, teleoperation, 3D modeling, prostheses, and exoskeletons.

scholarly journals A simple method of suspending implant wear particles for more physiological modelling of cell-particle interactions in vitro

2021 ◽  
Author(s):  
Christine Poon
Keyword(s):  
Wear Debris ◽  
Culture Media ◽  
Polymeric Materials ◽  
Wear Particle ◽  
Physicochemical Characteristics ◽  
Wear Particles ◽  
Simple Method ◽  
Implant Wear

AbstractArthroplasty implants e.g. hip, knee, spinal disc sustain relatively high compressive loading and friction wear, which lead to the formation of wear particles or debris between articulating surfaces. Despite advances in orthopaedic materials and surface treatments, the production of wear debris from any part of a joint arthroplasty implant is currently unavoidable. Implant wear debris induces host immune responses and inflammation, which causes patient pain and ultimately implant failure through progressive inflammation-mediated osteolysis and implant loosening, where the severity and rate of periprosthetic osteolysis depends on the material and physicochemical characteristics of the wear particles. Evaluating the cytotoxicity of implant wear particles is important for regulatory approved clinical application of arthroplasty implants, as is the study of cell-particle response pathways. However, the wear particles of polymeric materials commonly used for arthroplasty implants tend to float when placed in culture media, which limits their contact with cell cultures. This study reports a simple means of suspending wear particles in liquid medium using sodium carboxymethyl cellulose (NaCMC) to provide a more realistic proxy of the interaction between cells and tissues to wear particles in vivo, which are free-floating in synovial fluid within the joint cavity. Low concentrations of NaCMC dissolved in culture medium were found to be effective for suspending polymeric wear particles. Such suspensions may be used as more physiologically-relevant means for testing cellular responses to implant wear debris, as well as studying the combinative effects of shear and wear particle abrasion on cells in a dynamic culture environments such as perfused tissue-on-chip devices.

scholarly journals J0210205 In vivo analysis of the contact area in the metacarpophalangeal joint using MRI

2014 ◽  
Vol 2014 (0) ◽  
pp. _J0210205--_J0210205-
Author(s):  
Yuto KASUGA ◽  
Kiyoko KAZAMA ◽  
Makoto SAKAMOTO ◽  
Koichi KOBAYASHI
Keyword(s):  
Contact Area ◽  
Metacarpophalangeal Joint ◽  
In Vivo Analysis
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