Joyce Thomas J
School of Mechanical and Systems Engineering, Newcastle University, Newcastle upon Tyne, UK
Proc Inst Mech Eng H. 2016 May;230(5):450-7. doi: 10.1177/0954411915626943. Epub 2016 Feb 1.
Artificial finger joints lack the long-term clinical success seen with hip and knee prostheses. In part, this can be explained by the challenges of rheumatoid arthritis, a progressive disease which attacks surrounding tissues as well as the joint itself. Therefore, the natural finger joints' biomechanics are adversely affected, and consequently, this imbalance due to subluxing forces further challenges any prosthesis. Many different designs of finger prosthesis have been offered over a period of greater than 50 years. Most of these designs have failed, and it is likely that many of these failures could have been identified had the prostheses been appropriately tested prior to implantation into patients. While finger joint simulators have been designed, arguably only those from a single centre have been able to reproduce clinical-type failures of the finger prostheses tested in them. This article describes the design and development of a finger simulator at Durham University, UK. It explains and justifies the engineering decisions made and thus the evolution of the finger simulator. In vitro results and their linkage to clinical-type failures are outlined to help to show the effectiveness of the simulator. Failures of finger implants in vivo continue to occur, and the need for appropriate in vitro testing of finger prostheses remains strong.
人工手指关节缺乏髋关节和膝关节假体那样的长期临床成功案例。部分原因可以用类风湿性关节炎的挑战来解释，这是一种渐进性疾病，不仅会攻击关节本身，还会侵袭周围组织。因此，天然手指关节的生物力学受到不利影响，进而，由于半脱位力导致的这种失衡对任何假体都构成了更大挑战。在超过50年的时间里，人们提出了许多不同设计的手指假体。这些设计大多都失败了，如果在将假体植入患者之前进行适当测试，很可能许多失败情况是可以被发现的。虽然已经设计出了手指关节模拟器，但可以说只有来自单一中心的模拟器能够重现其中测试的手指假体的临床类型失败情况。本文描述了英国杜伦大学一款手指模拟器的设计与开发。它解释并说明了所做的工程决策以及手指模拟器的演变过程。概述了体外实验结果及其与临床类型失败情况的关联，以帮助展示模拟器的有效性。手指植入物在体内的失败仍在继续发生，对手指假体进行适当体外测试的需求依然强烈。
