Skip to main content

Advertisement

SpringerLink
Log in

Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

The total replacement of wrists affected by rheumatoid arthritis (RA) has had mixed outcomes in terms of failure rates. This study was therefore conducted to analyse the biomechanics of wrist arthroplasty using recently reported implants that have shown encouraging results with the aim of providing some insights for the future development of wrist implants. A model of a healthy wrist was developed using computed tomography images from a healthy volunteer. An RA model was simulated based on all ten general characteristics of the disease. The ReMotion ™ total wrist system was then modelled to simulate total wrist arthroplasty (TWA). Finite element analysis was performed with loads simulating the static hand grip action. The results show that the RA model produced distorted patterns of stress distribution with tenfold higher contact pressure than the healthy model. For the TWA model, contact pressure was found to be approximately fivefold lower than the RA model. Compared to the healthy model, significant improvements were observed for the TWA model with minor variations in the stress distribution. In conclusion, the modelled TWA reduced contact pressure between bones but did not restore the stress distribution to the normal healthy condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Abdul-Kadir MR, Hansen U, Klabunde R, Lucas D, Amis A (2008) Finite Element Modelling of Primary Hip Stem Stability: the Effect of Interference Fit. J Biomech 3:587–594

    Article  Google Scholar 

  2. Abdulghani S, Caetano-Lopes J, Canhão H, Fonseca JE (2009) Biomechanical effects of inflammatory diseases on bone-rheumatoid arthritis as a paradigm. Autoimmun Rev 8:668–671

    Article  PubMed  CAS  Google Scholar 

  3. Adams BD (2006) Total wrist arthroplasty for rheumatoid arthritis. International Congress Series 83–93

  4. Alkan I, Sertgöz A, Ekici B (2004) Influence of occlusal forces on stress distribution in preloaded dental implant screws. J Prosthet Dent 4:319–325

    Article  Google Scholar 

  5. Anderson DD, Deshpande BR, Daniel TE, Baratz ME (2005) A three-dimensional finite element model of the radiocarpal joint: distal radius fracture step-off and stress transfer. Iowa Orthop J 108–117

  6. Bajuri MN, Kadir MR, Raman MM, Kamarul T (2012) Mechanical and functional assessment of the wrist affected by rheumatoid arthritis: a finite element analysis. Med Eng Phys 34(9):1294–1302

    Article  PubMed  CAS  Google Scholar 

  7. Bettinger PC, Smutz WP, Linscheid RL, Cooney WP, An K-N (2000) Material properties of the trapezial and trapeziometacarpal ligaments. J Hand Surg 6:1085–1095

    Google Scholar 

  8. Bosisio MR, Talmant M, Skalli W, Laugier P, Mitton D (2007) Apparent Young’s modulus of human radius using inverse finite-element method. J Biomech 9:2022–2028

    Article  Google Scholar 

  9. Brown CP, Nguyen TC, Moody HR, Crawford RW, Oloyede A (2009) Assessment of common hyperelastic constitutive equations for describing normal and osteoarthritic articular cartilage. Proc Inst Mech Eng (H): J Eng Med 6:643–652

    Article  Google Scholar 

  10. Carrigan SD, Whiteside RA, Pichora DR, Small CF (2003) Development of a three-dimensional finite element model for carpal load transmission in a static neutral posture. Ann Biomed Eng 6:718–725

    Article  Google Scholar 

  11. Cavaliere CM, Chung KC (2008) Total wrist arthroplasty and total wrist arthrodesis in rheumatoid arthritis: a decision analysis from the hand surgeons’ perspective. J Hand Surg 10:1744–1755

    Google Scholar 

  12. Cheng H-YK, Lin C-L, Lin Y-H, Chen AC-Y (2007) Biomechanical evaluation of the modified double-plating fixation for the distal radius fracture. Clin Biomech 5:510–517

    Article  Google Scholar 

  13. Cush JJ, Lipsky PE (1991) Cellular basis for rheumatoid inflammation. Clin Orthop Relat Res 265:9–22

    Google Scholar 

  14. Dowson D, Fisher J, Jin ZM, Auger DD, Jobbins B (1991) Design Considerations for Cushion Form Bearings in Artificial Hip Joints. Archieve: Proc Inst Mech Eng (H): J Eng Med 1989–1996 (vols 203–210) 28: 59–68

  15. Finlay JB, Repo RU (1979) Energy absorbing ability of articular cartilage during impact. Med Biol Eng Comput 397–403

  16. Fischli S, Sellens RW, Beek M, Pichora DR (2009) Simulation of extension, radial and ulnar deviation of the wrist with a rigid body spring model. J Biomech 9:1363–1366

    Article  Google Scholar 

  17. Gislason MK, Nash DH, Nicol A, Kanellopoulos A, Bransby-Zachary M, Hems T, Condon B, Stansfield B (2009) A three-dimensional finite element model of maximal grip loading in the human wrist. Proc Inst Mech Eng (H): J Eng Med 7:849–861

    Article  Google Scholar 

  18. Gislason MK, Stansfield B, Nash DH (2010) Finite element model creation and stability considerations of complex biological articulation: the human wrist joint. Med Eng Phys 5:523–531

    Article  Google Scholar 

  19. Givissis PK, Antonarakos P, Vafiades VE, Christodoulou AG (2009) Management of posttraumatic arthritis of the wrist with radiolunate fusion enhanced with a sliding autograft: a case report and description of a novel technique. Tech Hand Up Extrem Surg 2:90–93

    Article  Google Scholar 

  20. Guo X, Fan Y, Li Z-M (2009) Effects of dividing the transverse carpal ligament on the mechanical behavior of the carpal bones under axial compressive load: a finite element study. Med Eng Phys 2:188–194

    Article  Google Scholar 

  21. Gupta A (2008) Total Wrist Athroplasty. J Orthop Res 37:12–16

    Google Scholar 

  22. Gupta S, Gollapudi S (2006) Molecular mechanisms of Tnf-alpha-induced apoptosis in naive and memory t cell subsets. Autoimmun Rev 4:264–268

    Article  Google Scholar 

  23. Herzberg G (2011) Prospective study of a new total wrist arthroplasty: short term results. Chirurgie de la Main 1:20–25

    Article  Google Scholar 

  24. Innovations SB (2009) Surgical Technique, Remotion™ Total Wrist Implant System. S. B. Innovations

  25. Ito Y, Corey Shum P, Shih AM, Soni BK, Nakahashi K (2006) Robust Generation of High-Quality Unstructured Meshes on Realistic Biomedical Geometry. Int J Numer Meth Eng 6:943–973

    Article  Google Scholar 

  26. James CB, Uhl TL (2001) A Review of Articular Cartilage Pathology and the Use of Glucosamine Sulfate. J Athl Train 4:413–419

    Google Scholar 

  27. Julkunen P, Wilson W, Jurvelin JS, Rieppo J, Qu C-J, Lammi MJ, Korhonen RK (2008) Stress-relaxation of human patellar articular cartilage in unconfined compression: prediction of mechanical response by tissue composition and structure. J Biomech 9:1978–1986

    Article  Google Scholar 

  28. Kerin AJ, Wisnom MR, Adams MA (1998) The Compressive Strength of Articular Cartilage. Proc Inst Mech Eng (H) 4:273–280

    Article  Google Scholar 

  29. Kobayashi M, Berger RA, Nagy L, Linscheid RL, Uchiyama S, Ritt M, An KN (1997) Normal kinematics of carpal bones: a three-dimensional analysis of carpal bone motion relative to the radius. J Biomech 8:787–793

    Article  Google Scholar 

  30. Li Z, Kim JE, Davidson JS, Etheridge BS, Alonso JE, Eberhardt AW (2007) Biomechanical response of the pubic symphysis in lateral pelvic impacts: a finite element study. J Biomech 12:2758–2766

    Article  Google Scholar 

  31. Macleod NA, Nash DH, Stansfield BW, Bransby-Zachary M, Hems T (2007) Cadaveric analysis of the wrist and forearm load distribution for finite element validation. In: Sixth International Hand and Wrist Biomechanics Symposium, Tainan, Taiwan, Republic of China, 11

  32. Materialise (2008) Mimics Help Manual. Materialise

  33. McGrouther DA HP, Interactive Hand-Anatomy Cd, Primal Pictures, V.1.0

  34. Menon J (1998) Universal total wrist implant : experience with a carpal component fixed with three screws. J Arthroplasty 5:515–523

    Article  Google Scholar 

  35. Metz VM, Metz-Schimmerl SM, Yin Y (1997) Ligamentous instabilities of the wrist. Eur J Radiol 2:104–111

    Article  Google Scholar 

  36. Murali P, Bhandakkar TK, Cheah WL, Jhon MH, Gao H, Ahluwalia R (2011) Role of modulus mismatch on crack propagation and toughness enhancement in bioinspired composites. Phys Rev E 1:015102

    Article  Google Scholar 

  37. Patterson RM, Viegas SF, Elder K, Buford WL (1995) Quantification of anatomic, geometric, and load transfer characteristics of the wrist joint. Semin Arthroplasty 1:13–19

    Google Scholar 

  38. Polikeit A, Nolte LP, Ferguson SJSJ (2004) simulated influence of osteoporosis and disc degeneration on the load transfer in a lumbar functional spinal unit. J Biomech 7:1061–1069

    Article  Google Scholar 

  39. Radmer S, Andresen R, Sparmann M (1999) Wrist arthroplasty with a new generation of prostheses in patients with rheumatoid arthritis. J Hand Surg 5:935–943

    Google Scholar 

  40. Raja Izaham RM, Abdul Kadir MR, Abdul Rashid AH, Hossain MG, Kamarul T (2012) Finite element analysis of puddu and tomofix plate fixation for open wedge high tibial osteotomy. Injury 43(6):898–902

    Article  PubMed  Google Scholar 

  41. Savelberg HH, Kooloos JG, Huiskes R, Kauer JM (1992) Stiffness of the ligaments of the human wrist joint. J Biomech 25:369–376

    Google Scholar 

  42. Schuind F, Cooney WP, Linscheid RL, An KN, Chao EYS (1995) Force and pressure transmission through the normal wrist. A theoretical two-dimensional study in the posteroanterior plane. J Biomech 5:587–601

    Article  Google Scholar 

  43. Simmen BR, Kolling C, Herren DB (2007) The management of the rheumatoid wrist. Current Orthop 5:344–357

    Article  Google Scholar 

  44. Soltz MA, Ateshian GA (2000) A conewise linear elasticity mixture model for the analysis of tension-compression nonlinearity in articular cartilage. J Biomech Eng 6:576–586

    Article  Google Scholar 

  45. Stegeman M, Rijnberg WJ, van Loon CJM (2005) Biaxial total wrist arthroplasty in rheumatoid arthritis. Satisfactory functional results. Rheumatol Int 3:191–194

    Article  Google Scholar 

  46. Sun D, Wharton JA, Wood RJK (2009) Micro-abrasion-corrosion of cast CoCrMo—effects of micron and sub-micron sized abrasives. Wear 1–4:52–60

    Article  Google Scholar 

  47. Tajdari M, Javadi M (2006) A new experimental procedure of evaluating the friction coefficient in elastic and plastic regions. J Mater Process Technol 1–3:247–250

    Article  Google Scholar 

  48. Trieb K, Hofstätter S (2009) Rheumatoid arthritis of the wrist. Tech Orthop 1:8–12

    Article  Google Scholar 

  49. Trieb K, Hofstätter S (2009) Treatment Strategies in Surgery for Rheumatoid Arthritis. Eur J Radiol 2:204–210

    Article  Google Scholar 

  50. Vuckovic A, Sepulveda F (2008) Delta band contribution in cue based single trial classification of real and imaginary wrist movements. Med Biol Eng Comput 6:529–539

    Article  Google Scholar 

  51. Wilson W, van Donkelaar CC, van Rietbergen B, Ito K, Huiskes R (2004) Stresses in the local collagen network of articular cartilage: a poroviscoelastic fibril-reinforced finite element study. J Biomech 3:357–366

    Article  Google Scholar 

  52. Yang H, Ma X, Guo T (2010) Some factors that affect the comparison between isotropic and orthotropic inhomogeneous finite element material models of femur. Med Eng Phys 6:553–560

    Article  Google Scholar 

  53. Youm Y, Flatt AE (1980) Kinematics of the wrist. Clin Orthop Relat Res 21–32

  54. Zander T, Rohlmann A, Klöckner C, Bergmann G (2002) Effect of bone graft characteristics on the mechanical behavior of the lumbar spine. J Biomech 4:491–497

    Article  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Dedy Wicaksono from the Medical Implant Technology Group, Universiti Teknologi Malaysia and Iskandar Mohd Amin from the Orthopaedic Department, Hospital Universiti Sains Malaysia for their valuable comments and supports.

Author information

Authors and Affiliations

  1. Faculty of Health Science and Biomedical Engineering, Medical Implant Technology Group, Universiti Teknologi Malaysia (UTM), 81310, Johor Bahru, Johor, Malaysia

    M. N. Bajuri & Mohammed Rafiq Abdul Kadir

  2. Faculty of Medicine, Tissue Engineering Group (TEG), Department of Orthopaedic surgery, National Orthopaedic Centre of Excellence in Research and learning (NOCERAL), University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia

    Malliga Raman Murali & T. Kamarul

Authors
  1. M. N. Bajuri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammed Rafiq Abdul Kadir
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Malliga Raman Murali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Kamarul
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammed Rafiq Abdul Kadir.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bajuri, M.N., Abdul Kadir, M.R., Murali, M.R. et al. Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis. Med Biol Eng Comput 51, 175–186 (2013). https://doi.org/10.1007/s11517-012-0982-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-012-0982-9

Keywords

Search

Navigation