In-situ simulation of one-piece metacarpophalangeal joint implants using finite element analysis.

Generally, reconstruction of the rheumatoid metacarpophalangeal (MCP) joint is achieved by means of implantation of a hinged silastic prosthesis. Whereas these implants restore some degree of mobility to the joint, they are prone to failure after a relatively short life-span, and little is known about their dynamical behaviour within the joint. In this study, the Swanson and Sutter designs of MCP implant were examined in an idealized joint environment by means of two-dimensional finite element analysis. The purpose was to assess how the differing geometry affected their behaviour as replacement joints, and whether they were inherently prone to abrasion and high stress concentrations during flexion. The results revealed the changing points of contact between the implant and the bone ends, and clearly showed the implant stems 'pistoning' in the intramedullary canals. This was found to be an effective way to provide preliminary information on the dynamic behaviour of an implant in a simulated joint. This would facilitate further optimization of design in advance of fabrication.