Цифровое моделирование критических состояний эндопротезирования пястно‑фалангового сустава

Abstract

Introduction The current status of small joint arthroplasty, the metacarpophalangeal joint replacement, in particular, dictates the need for development and research of new implant designs and materials for their manufacture. The vector of development of anatomically adapted implants has become established, and full preclinical study is required to obtain the best functional results from the use of new medical devices. The objective was to analyze digital models of critical conditions of metacarpophalangeal joint replacement using mechanical and clinical data. Material and methods A two‑component all-ceramic, anatomically adapted endoprosthesis of the metacarpophalangeal joint was developed between 2017 and 2021. A digital model of the metacarpophalangeal joint endoprosthesis was constructed using 3D modeling technology. Critical conditions of the digital model imitating the main stereotypes of movements were explored with the finite element method; objective technical results obtained and interpreted in a clinical language. Results Loads over 20 kg should be avoided with movements up to 60° in the early postoperative period. The load must not exceed 10 kg for motion ranging between 60° and 90°. The endoprosthesis allowed for a functional range of motion of 30-60° after MCP joint replacement without significant risks of complications. Discussion The study has demonstrated the importance of objectifying clinical results to minimize the risk of complications in a clinical scenario. Conclusion The technology based on a digital model of the metacarpophalangeal joint constructed to calculate critical conditions using the Ansys software facilitated prediction of most common complications of MCP arthroplasty and preceded further multicentric clinical trials.