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Titanium basal joint arthroplasty: a finite element analysis and clinical study
Sanjiv H Naidu1, Nikhil Kulkarni, Marnie Saunders
1Department of Orthopaedic Surgery and Rehabilitation, the Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
The Journal of Hand Surgery
|May 23, 2006
Summary
Titanium implants for trapeziometacarpal arthritis showed high early failure rates in this study, contrary to anecdotal reports. The finite element analysis confirmed mechanical issues, suggesting limited use for low-demand patients.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Hand surgery
Background:
- Trapeziometacarpal arthritis significantly impacts hand function.
- Titanium implant arthroplasty is an option for basal joint arthritis.
- Previous success rates for titanium implants are anecdotally reported as high.
Purpose of the Study:
- To define the mechanics of titanium implant arthroplasty in trapeziometacarpal arthritis.
- To determine the clinical outcomes of this procedure.
Main Methods:
- Finite element analysis (FEA) to model implant mechanics.
- Clinical study of 50 thumbs with Eaton stage 3 arthritis treated with titanium arthroplasty.
- Pre- and post-operative Disabilities of the Arm, Shoulder, and Hand (DASH) scores and grip/pinch strength measurements.
Main Results:
- FEA revealed implant pistoning and high stress concentrations.
- Clinical study showed a 20% failure rate within 9 months, requiring revision.
- Remaining patients had improved DASH scores but persistent weakness and swelling.
Conclusions:
- Titanium implant arthroplasty demonstrated high early failure rates, contradicting anecdotal evidence.
- FEA findings correlated with clinical results.
- The procedure may be suitable for low-demand patients with good bone stock; however, it was discontinued at the institution.
