FEA analysis of silicone MCP implant

Biomechanical comparative finite element analysis between a conventional proximal interphalangeal joint flexible hinge implant and a novel implant design using a rolling contact joint mechanism

BACKGROUND

The rolling contact joint (RCJ) mechanism is a system of constraint that allows two circular bodies connected with flexible straps to roll relative to one another without slipping. This study aims to compare the biomechanical characteristics between the conventional proximal interphalangeal joint (PIPJ) flexible hinge (FH) implant and the novel PIPJ implant adopting a RCJ mechanism during PIPJ range of motion using finite element (FE) analysis.

METHODS

The three-dimensional (3D) surface shape of a conventional PIPJ FH implant was obtained using a 3D laser surface scanning system. The configuration and parameters of the novel PIPJ implant were adapted from a previous study. The two implants were assumed to have the same material characteristics and each implant was composed of a hyperelastic material, silicone elastomers. The configuration data for both implants were imported to a computer-aided design program to generate 3D geometrical surface and hyperelastic models of both implants. The hyperelastic models of both implants were imported into a structural engineering software to produce the FE mesh and to perform FE analysis. The FE analysis modeled the changes of mechanics during flexion-extension motion between 0° and 90° of two PIPJ implants. The mean and maximum values of von-Mises stress and strain as well as the total moment reaction based on the range of motion of the PIPJs were calculated. The mean values within the PIPJ's functional range of motion of the mean and maxinum von-Mises stress and strain and the total moment reaction were also determined.

RESULTS

The maximum values for the von-Mises stress, and strain, as well as the total moment reactions of the conventional PIPJ FH and novel PIPJ implants were all at 90° of PIPJ flexion. The maximum value of each biomechanical property for the novel PIPJ implant was considerably lower compared with that of the conventional PIPJ FH implant. The mean values within the PIPJ's functional range of motion of the maximum von-Mises stress and strain for the novel PIPJ implant was approximately 6.43- and 6.46-fold lower compared with that of the conventional PIPJ FH implant, respectively. The mean value within a PIPJ's functional range of motion of the total moment reaction of the novel PIPJ implant was approximately 49.6-fold lower compared with that of the conventional PIPJ FH implant.

CONCLUSIONS

The novel PIPJ implant with an RCJ mechanism may offer improved biomechanical performance compared with conventional PIPJ FH implant.

The silicone metacarpophalangeal joint arthroplasty: An in-vitro analysis

BACKGROUND

Silicone is still the gold standard implant in metacarpophalangeal arthroplasty. Whereas the clinical results are acceptable, in follow-ups with >10 years, high rates of implant fracture are common, and 5 to 7% of implants required revision. This work's purpose is to analyse the hypothesis that the joint flexion amplitude has a relevant effect on bone strain level, implant stress and bone-implant micromotion, which can reflect an increase in the risk of bone resorption/fatigue failure, implant fracture and osteolysis.

METHODS

To experimentally predict the cortical loading behaviour, composite metacarpals and proximal phalanges were used in intact and implanted states. A finite element model was developed to evaluate the structural behaviour of cancellous bone and implant. This model was validated by comparing cortical strain and load-displacement curve with experimental measurements.

FINDINGS

Bone strain changes between the intact and the implanted states showed a load transfer effect from the cortical to the cancellous bone that increases significantly with the flexion's amplitude rise. The peak implant stress occurred in the flexion amplitudes further away from the implant neutral angle. The highest implant pistoning motion and the highest phalanx cancellous-bone strain occurred simultaneously at the maximum flexion amplitude.

INTERPRETATION

Limiting joint flexion range will be helpful to reduce the strain-shielding effect on cortical bone, minimizing the overload effect on cancellous bone and decreasing the stress levels and the pistoning motion on the implant, ultimately contributing to the longevity of silicone arthroplasty.

Analytical Modeling for Computing Lead Stress in a Novel Epicardial Micropacemaker

Implantation and maintenance of a permanent cardiac pacing system in children remains challenging due to small patient size, congenital heart defects and somatic growth. We are developing a novel epicardial micropacemaker for children that can be implanted on the epicardium within the pericardial space via a minimally-invasive technique. The key design configurations include a novel open-coiled lead in which living tissue replaces the usual polymeric support for the coiled conductor. To better understand and be able to predict the behavior of the implanted lead, we performed a radiographic image-based modeling study on a chronic animal test. We report a pilot study in which two mechanical dummy pacemakers with epicardial leads were implanted into an adult pig model via a minimally invasive approach. Fluoroscopy was obtained on the animal on Post-Operative Days #9, #35 and #56 (necropsy). We then constructed an analytic model to estimate the in vivo stress conditions on the open-coil lead based on the analysis of orthogonal biplane radiographic images. We obtained geometric deformation data of the implanted lead including elongation magnitudes and bending radii from sequenced films of cardiac motion cycles. The lead stress distribution was investigated on each film frame and the point of maximum stress (Mean Stress = 531.4 MPa; Alternating Stress = ± 216.4 MPa) was consistently where one of the leads exited the pericardial space, a deployment that we expected to be unfavorable. These results suggest the modeling approach can provide a basis for further design optimization. More animal tests and modeling will be needed to validate whether the novel lead design could meet the requirements to withstand ~200 million cardiac motion cycles over 5 years.

Biomechanical validation of finite element models for two silicone metacarpophalangeal joint implants

Silicone implants are used for prosthetic arthroplasty of metacarpophalangeal (MCP) joints severely damaged by rheumatoid arthritis. Different silicone elastomer MCP implant designs have been developed, including the Swanson and the NeuFlex implants. The goal of this study was to compare the in vitro mechanical behavior of Swanson and NeuFlex MCP joint implants. Three-dimensional (3D) finite element (FE) models of the silicone implants were modeled using the commercial software ANSYS and subjected to angular displacement from 0 deg to 90 deg. FE models were validated using mechanical tests of implants incrementally bent from 0 deg to 90 deg in a joint simulator. Swanson size 2 and 4 implants were compared with NeuFlex size 10 and 30 implants, respectively. Good agreement was observed throughout the range of motion for the flexion bending moment derived from 3D FE models and mechanical tests. From 30 deg to 90 deg, the Swanson 2 demonstrated a greater resistance to deformation than the NeuFlex 10 and required a greater bending moment for joint flexion. For larger implant sizes, the NeuFlex 30 had a steeper moment-displacement curve, but required a lower moment than the Swanson 4, due to implant preflexion. On average, the stress generated at the implant hinge from 30 deg to 90 deg was lower in the NeuFlex than in the Swanson. On average, starting from the neutral position of 30 deg for the preflexed NeuFlex implant, higher moments were required to extend the NeuFlex implants to 0 deg compared with the Swanson implants, which returned spontaneously to resting position. Implant toggling within the medullary canals was less in the NeuFlex than in the Swanson. The differential performance of these implants may be useful in implant selection based on the preoperative condition(s) of the joint and specific patient functional needs.

Frequency dependence of viscoelastic properties of medical grade silicones

Cylinders of medical grade silicone elastomers, (29 mm in diameter and 13 mm thick), immersed in physiological saline solution at 37 degrees C, were investigated by dynamic mechanical analysis (DMA). A sinusoidal cyclic compression of 40 +/- 5 N was applied over a frequency range, f, of 0.02-100 Hz. Values of the storage, E', and loss, E'', moduli for the cylinders were found to depend on f; the dependence of E' or E'' on the logarithm (base 10) of f was represented by a third-order polynomial. Above about 0.3 Hz, the cylindrical specimens appeared to be undergoing the onset of a transition from the rubbery to the glassy state. There was no significant difference between results obtained at 37 and 23 degrees C; pretreatment of specimens in physiological saline at 37 degrees C for 24 h and 29 days had no appreciable effect on the results.

Crack growth of medical-grade silicone using pure shear tests

Silicone elastomers are commonly used in the manufacture of single-piece joint replacement implants for the finger joints. However, the survivorship of these implants can be poor, with failure typically occurring from fracture of the stems. The aim of this paper was to investigate the crack growth of medical-grade silicone using pure shear tests. Two medical-grade silicones (C6-180 and Med82-5010-80) were tested. Each sample had a 20 mm crack introduced and was subjected to a sinusoidally varying tensile strain, with a minimum of 0 per cent and a maximum in the range 10 to 77 per cent. Testing was undertaken at a frequency of 10 Hz. At various times during testing, the testing machine was stopped, the number of cycles completed was noted, and the crack length measured. Graphs of crack length against number of cycles were plotted, as well as the crack growth rate against tearing energy. The results show that Med82-5010-80 is more crack resistant than C6-180. Graphs of crack growth rate against tearing energy can be used to predict the failure of these medical-grade elastomers.