Martínez Bocanegra Marco A, Bayod Lopez Javier, Vidal-Lesso A, Becerro de Bengoa Vallejo Ricardo, Lesso-Arroyo Raúl
Department of Mechanical Engineering, Universidad de Guanajuato-DICIS, Mexico.
Group of Structural Mechanics and Materials Modeling (GEMM), Aragon Institute of Engineering Research (I3A), Universidad de Zaragoza, Spain.
Foot Ankle Surg. 2019 Apr;25(2):150-157. doi: 10.1016/j.fas.2017.10.002. Epub 2017 Oct 20.
Currently, the metatarsophalangeal joint replacement through a restorative arthroplasty, where implants are used, is a viable invasive surgical medical procedure in the treatment of severe cases of osteoarthritis in this joint, better known as hallux rigidus. However, few things are known about the postoperative complications that implants can cause on the joint, like Swanson and Tornier implants.Research in this field can provide a valuable information that would help the specialist surgeon in the decision-making during the selection of the more suitable joint implant in each patient, as well as the redesign of the devices, to make them more efficient, durable and biocompatible with the human body.
The aim of this work is to perform a structural biomechanical analysis of a restorative arthroplasty of the first metatarsophalangeal joint, and to analyze the interaction between bone and medical grade silicone implants. For that, a simulation of a foot with Swanson and Tornier joint implants were performed to evaluate the stress/strain distribution during a critical stage (toe-off).
Principal stresses obtained for the first metatarsal with both implants suggest that failure is induced in this bone because, values exceed (up to 136.84% for Swanson model) the tensile strength reported for phalange trabecular bone, which may be related to osteolysis. Stress and strain values obtained in this work suggest that arthroplasty surgery with Swanson implant is more likely to cause postoperative complications versus Tornier implant.
目前，通过使用植入物的修复性关节成形术进行跖趾关节置换，是治疗该关节严重骨关节炎（即众所周知的僵硬拇趾）的一种可行的侵入性外科手术。然而，对于像斯旺森（Swanson）和 Tornier 植入物这样的植入物在关节上可能引起的术后并发症，人们了解甚少。该领域的研究可以提供有价值的信息，这将有助于专科医生在为每位患者选择更合适的关节植入物时进行决策，以及对器械进行重新设计，使其更高效、耐用且与人体具有生物相容性。
这项工作的目的是对第一跖趾关节的修复性关节成形术进行结构生物力学分析，并分析骨骼与医用级硅胶植入物之间的相互作用。为此，对带有斯旺森和 Tornier 关节植入物的足部进行了模拟，以评估关键阶段（足趾离地）的应力/应变分布。
两种植入物在第一跖骨上获得的主应力表明，该骨骼会发生失效，因为其值超过了趾骨小梁骨报告的拉伸强度（斯旺森模型高达 136.84%），这可能与骨质溶解有关。这项工作中获得的应力和应变值表明，与 Tornier 植入物相比，使用斯旺森植入物进行关节成形术更有可能引起术后并发症。
