To fix or not to fix!? Strategies and tools to place and fixate a flexible joint implant

Abstract

Osteoarthritis (OA) is a prevalent type of degenerative arthritis resulting from cartilage wear and tear, predominantly affecting joints like the knee, hand, and hip. Specifically, hand OA often impacts multiple hand joints, leading to significant patient loss of function and discomfort and substantial costs related to diagnostics, treatment, and productivity losses.When conservative treatments fail to alleviate pain and functional issues in hand OA, surgical intervention becomes necessary. Numerous arthroplasty implants exist for various finger joints, but often complications occur, like implant loosening and dislocation. Despite advancements in joint prosthetic design, the overall outcome has shown minimal improvement over time.The APRICOT® (Anatomically Precise Revolutionary Implant for bone Conserving Osteoarthritis Treatment) patented by Aurora Medical Ltd (Chichester, UK) represents a groundbreaking solution to address the challenges posed by existing finger joint implants for osteoarthritis. This innovative implant is specifically tailored for small joints affected by osteoarthritis, offering a self-lubricated polymeric sac that mimics the natural joint's low-friction characteristics. Unlike conventional implants, APRICOT® facilitates full joint range of motion through its unique caterpillar-like internal motion, supported by an internal lubricant coating that minimizes friction. Currently in its proof-of-concept phase, the APRICOT® project aims to overcome significant challenges associated with osteoarthritis treatment in small joints. Key objectives of this thesis include identifying a required anchoring system for secure implant fixation, establishing an effective implantation strategy, and designing and testing specialized surgical instruments to facilitate the implantation process.