Influence of plate position on the first metatarsophalangeal joint arthrodesis - Project - Bridge of Knowledge

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Influence of plate position on the first metatarsophalangeal joint arthrodesis

Arthrodesis, i.e. fixation of the first metatarsophalangeal joint (MTP1) is a safe procedure in the treatment of advanced stages of degenerative disease and deformities of the hallux. The use of the dorsal plate in conjunction with a lag screw is described as the most stable fixation method of MTP1 joint. However, the number of revisions after arthrodesis can be up to 20%, therefore there is still a need to determine new methods of MTP1 joint fixation. At the Medical University of Gdańsk, a team of surgeons with whom we cooperate proposed the use of a medially positioned plate as an innovative alternative to the existing methods. The trial application of the proposed method in patients gave promising results and a low number of complications. Considering the forces in the MTP1 joint, a change in the position of the plate may provide greater stiffness after arthrodesis. In the pilot study, it is planned to compare the bone fixation in the MTP1 joint arthrodesis with the use of medially positioned plate and a dorsally positioned plate. Additionally, the influence of use of a compression lag screw will be investigated. For each method of joint fixation, tests will be performed in a testing machine for 5 pairs of bones printed on a 3D printer from PLA material and then fused with titanium plates and screws. Strength tests will be carried out to failure of the MTP1 joint fusion in order to determine the stiffness of the fixation and its load-bearing capacity. According to the literature, greater stiffness promotes better bone union, while greater strength of the bone fixation in the MTP1 joint fusion may shorten the period of non-weight-bearing. The results from the experimental tests will be used to validate the three-dimensional models of the MTP1 joint in the finite element method (FEM). The use of FEM will allow for a detailed biomechanical analysis of the joint fusion and determination of the values of stresses and displacements in each point of the joint. Conducting a pilot study would allow applying for a larger research project that would model bone union in the MTP1 joint. The FEM model validated under the MINIATURA project could be used to develop new medially positioned plates for arthrodesis of the hallux. This type of research could be carried out in cooperation with the industry and commercialized in the future.

Details

Financial Program Name:
MINIATURA
Organization:
Narodowe Centrum Nauki (NCN) (National Science Centre)
Agreement:
z dnia 2021-10-01
Realisation period:
2021-10-01 - 2022-09-30
Project manager:
dr inż. Karol Daszkiewicz
Realised in:
Katedra Wytrzymałości Materiałów
Request type:
National Research Programmes
Domestic:
Domestic project
Verified by:
Gdańsk University of Technology

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