Structural interaction between bone and implants due to arthroplasty of the first metatarsophalangeal joint

Abstract

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.

Biomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element StudyBiomechanical Evaluation of Hemiarthroplasty in the First Proximal Phalanx. A Finite Element Study

“…Some authors have reported metatarsalgia in the second toe as a side effect of the first phalangeal arthroplasty [21] [22] and Garcia-Aznar et al have shown that when the FRotF is unloaded, the others are overloaded, thus increasing the risk of metatarsalgia [24] [17] . For the healthy model, the results have a good correlation with a similar models presented by Enrique Morales et al [15] , Marco A. Martinez et al [4] and Mario Alberto Madrid et al [9] . These are the same model with minor modifications through various researches, while for the implant model there is no experimental validation because nobody has done it before, however there are clinical results that coincide with the results obtained in the implant model [21] [22] .…”

“…There are three different types of arthroplasty: The interposition arthroplasty where some tissue is interposed, such as a muscle or a tendon to keep some distance between the bones. The resection arthroplasty where the resected bone is removed and the implant arthroplasty where the bony surfaces of proximal phalanx and/or head of first metatarsal bone are removed and replaced by an implant [4] . The surgical treatment and the type of technique to be used depend on the stage in which it is found and the morphological type of the forefoot.…”

“…Finite element models are a good technique to understand these effects [4] [7] [8] [9] and are more economical and easier to carry out than experimental ones (either in vivo or on cadavers). Reference [4] discusses a foot model after an arthroplasty has been developed using two types of implants, Swanson and Tornier joint implants. Reference [7] makes an analysis of the foot varying the size of the first proximal phalanx.…”

Structural assessment of pre-flexion in silicone implants for arthroplasty of the first metatarsophalangeal joint

“…The maximum stress concentration zone was located at the implant hinge, so the maximum stress and strain values were taken from this part of the model, according to Martinez Bocanegra et al 27 Maximum von Mises stress at 64°, was obtained of the hyperelastic model with a value of 2.022 while, 1.82 MPa was the stress value obtained for the elastic model with small strains. The difference in stress between these models resulted in a 10% value.…”

“…Related to numerical methods applied to these implants, it can be used to analyze the structural behavior of the foot and implant during the gait cycle and to analyze some of the post-operative effects and pathologies. Previous works 24–31 have reported finite element foot models to study biomechanics, pathologies, and structural response of bones and soft tissues in this member. However, these models have not included the state of stress of Swanson or Tornier implants due to pre-flexion to characterize the arthroplasty of the first metatarsophalangeal joint.…”