Kolsanov AV, Nikolaenko AN, Ivanov VV, Grankin IO, Isaikin PY, Doroganov SO, Zgirsky DO, Kotelnikov GP. [Biomechanics of the first metatarsophalangeal joint after replacement].
Khirurgiia (Mosk) 2023:58-64. [PMID:
37186652 DOI:
10.17116/hirurgia202305158]
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Abstract
OBJECTIVE
Analysis of biomechanics of the first metatarsophalangeal joint after arthroplasty, interaction between bones and two implants of the first metatarsophalangeal joint using skeletal model of the foot.
MATERIAL AND METHODS
We developed anatomically adapted all-ceramic non-coupled endoprosthesis of proximal interphalangeal joint between 2016 and 2021. To create a model of the foot, we used diagnostic computed tomography whose images were applied in 3D sculpting system and computer-aided design system for final geometric modeling of the joint.
RESULTS
In dorsal flexion of the first metatarsophalangeal joint under 45° with the presence of implant, cortical bone tissue can withstand a load of up to 40 kg. Cortical bone tissue with implant can withstand a load of up to 305 kg without dorsal flexion. Strength of implant elements made of zirconium ceramics significantly exceeds strength of bone tissue within implant-bone tissue connection.
CONCLUSION
Postoperative axial load on the first metatarsophalangeal joint up to 35 kg with maximum dorsal flexion up to 45° is the most appropriate. Higher load and hyperextension over 45° may be followed by postoperative complications such as implant instability, dislocation and periprosthetic fracture.
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