Metacarpophalangeal Joint Prostheses: A Review of past and Current Designs

Beevers, D J; Seedhom, B B

doi:10.1243/pime_proc_1993_207_297_02

Cited by 52 publications

(41 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These implants have been discontinued because of their high complication rate due to loosening and fracture [ 12 ]. …”

Section: Implant Designs Hinged Metallic Prosthesismentioning

confidence: 99%

Treatment of MCP Joints in the Rheumatoid Hand

Lluch

2016

Clinical Management of the Rheumatoid Hand, Wrist, and Elbow

View full text Add to dashboard Cite

The fi nger extensor tendons do not insert at the base of the proximal phalanx , as they need to glide proximally and distally to provide extension of the interphalangeal joints (IPJ). The extensor tendons are stabilized at the dorsum of the metacarpal heads by two aponeurotic expansions, the sagittal bands (SB), which insert at both sides of the volar plate of the metacarpophalangeal joints (MPJ). The SB are responsible for maintaining the extensor tendon at the dorsum of the joint during radial and ulnar inclination of the fi ngers, as well as allowing the tendon to glide proximally and distally during extension and fl exion of the fi nger joints. If the intrinsic muscles are paralyzed, as seen after median and ulnar nerve lesions, the extensor tendon will only extend the MPJ, causing a claw deformity of the fi ngers. In these circumstances, if the MPJ are passively held in fl exion, because the extensor tendon does not insert into the proximal phalanx (PP), it will be capable of extending the IP joints.The fl exion forces at the MPJ, provided by the extrinsic fl exors and the intrinsic musculature, are far greater than the extension force provided by the extensor tendon. The collateral ligaments (CL) originate on the dorsum of the metacarpals and insert at the most anterior part of the base of the proximal phalanx, for the purpose of preventing the PP from displacing anteriorly. Anterior displacement of the PP is also prevented by the ball and socket joint morphology, as well as the constraint of the SB, which insert at both sides of the volar plate and should be considered as a proximal extension of the PP.Synovitis of the MPJ will attenuate the collateral ligaments (CL) and the SB, allowing the PP to displace volarly from the pull of the extrinsic and intrinsic fl exor muscles. The intensity and characteristics of the joint synovitis, as seen in cases of lupus, may rapidly destroy the CL and both SB, causing a complete anterior dislocation of the PP. When the dorsal stabilizers are not completely disrupted, the PP will partially sublux causing a scalloping deformity from wear of the dorsal part at its base.Another common deformity is an ulnar inclination of the fi ngers, known as ulnar drift. There is no single cause for the ulnar drift deformity, but rather a combination of several factors and the relative importance of each of them are diffi cult to determine. The following causes have been described as contributing to ulnar drift of the fi ngers in the rheumatoid hand: gravity, thumb

show abstract

“…These implants have been discontinued because of their high complication rate due to loosening and fracture [ 12 ]. …”

Section: Implant Designs Hinged Metallic Prosthesismentioning

confidence: 99%

Treatment of MCP Joints in the Rheumatoid Hand

Lluch

2016

Clinical Management of the Rheumatoid Hand, Wrist, and Elbow

View full text Add to dashboard Cite

show abstract

“…Currently, in many hand biomechanics studies, moment arms for the index muscles are assumed to be constant due to lack of available moment arm variation models. To demonstrate the effects of such an assumption, we predicted the finger path using a constant moment arm matrix R c , given by (6). The constant moment arm values were determined by measuring the approximate distance between the joint centers and tendon locations from the ACT finger drawings when all the joint angles are at zero …”

Section: Validationmentioning

confidence: 99%

“…The determination of the variations in the moment arms is important for other hand applications as well. Determination of moment arm variations would help in testing the viability of hand implants [6], [40]. It would be an important part of a biomechanical model of finger dynamics [11], [28] and control [20].…”

Section: E Future Implicationsmentioning

confidence: 99%

Acquiring Variable Moment Arms for Index Finger Using a Robotic Testbed

Deshpande

Balasubramanian

et al. 2010

IEEE Trans. Biomed. Eng.

View full text Add to dashboard Cite

Abstract-Human level of dexterity has not been duplicated in a robotic form to date. Dexterity is achieved in part due to the biomechanical structure of the human body and in part due to the neural control of movement. We have developed an anatomically correct testbed (ACT) hand to investigate the importance and behavioral consequences of anatomical features and neural control strategies of the human hand. One of the critical aspects of understanding dexterity is the analysis of the relationships between the hand muscle movements and joint movements, defined by the moment arms of the muscles. It is known that the moment arms for the hand muscles are configuration-dependent and vary substantially with change in posture. This paper presents a methodology for determining continuous variations in the moment arms with respect to multiple joints moving simultaneously. To determine variations in the moment arms of the ACT hand index finger muscles, we employed a nonparametric regression method called Gaussian processes (GPs). GPs give a functional mapping between the joint angles and muscle excursions, and the gradients of these mappings are the muscle moment arms. We compared the moment arm relationships of the ACT hand with those determined from the available cadaver data. We present the implications of the determination of variable moment arms toward understanding of the biomechanical properties of the human hand and for the neuromuscular control for the ACT hand index finger movements.

show abstract

“…For the MCP joint, the surgical procedure involves cutting to remove the bone ends of the joint and broaching the shaft of the bone to create a cavity for the implant stems. There is a variety of designs of finger joints available and they can be broadly divided into single-piece silicone joints and articulating bearing surface joints [43,44].…”

Section: Finger Joint Replacementmentioning

confidence: 99%

Joint Replacement Implants

Shepherd

2010

Biomechanics of Hard Tissues

View full text Add to dashboard Cite

Metacarpophalangeal Joint Prostheses: A Review of past and Current Designs

Cited by 52 publications

References 85 publications

Treatment of MCP Joints in the Rheumatoid Hand

Treatment of MCP Joints in the Rheumatoid Hand

Acquiring Variable Moment Arms for Index Finger Using a Robotic Testbed

Joint Replacement Implants

Contact Info

Product

Resources

About