Biomechanical analysis of cadaveric wrists before and after MOTEC wrist arthroplasty using a hexapod robot.

Gregory I Bain, Simon F Bellringer, Michael P Russo, Dhara Amin, John J Costi
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Abstract

This study compares wrist motion, biomechanical behaviour and radiographic parameters before and after total wrist arthroplasty using a fourth-generation spherical articulation prosthesis. A total of 10 cadaveric specimens were assessed using a hexapod Stewart platform robot. After arthroplasty, there were significant increases in both stiffness and phase angle of wrist motion across all planes of motion assessed. In three specimens, a sudden increase in moment was observed on load/displacement curves. Radiographically, carpal height increased by 14%, and the centre of rotation was displaced 11.1 mm proximally, 4.6 mm dorsally and 3.9 mm radially. This stretched the musculotendinous units, tightening the joint, while increasing the moment arm of the wrist flexors and decreasing the moment arm of the extensors, potentially important in the development of postoperative flexion contractures. Possible alterations in technique and/or implant design are considered to assist surgeons in achieving optimal clinical and survivorship outcomes.

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使用六足机器人对 MOTEC 腕关节置换术前后的尸体腕部进行生物力学分析。
这项研究比较了使用第四代球形关节假体进行全腕关节置换术前后的腕关节运动、生物力学行为和放射学参数。使用六足 Stewart 平台机器人对 10 具尸体标本进行了评估。关节置换术后,在所有评估的运动平面上,腕关节运动的硬度和相位角都有显著增加。在三个标本中,观察到载荷/位移曲线上的力矩突然增加。从影像学角度看,腕骨高度增加了 14%,旋转中心向近端移动了 11.1 毫米,向背移动了 4.6 毫米,向径向移动了 3.9 毫米。这拉伸了肌肉腱膜单元,收紧了关节,同时增加了腕关节屈肌的力矩臂,减少了腕关节伸肌的力矩臂,可能对术后屈曲挛缩的发生有重要影响。考虑对技术和/或植入物设计进行可能的改变,以帮助外科医生获得最佳的临床和存活效果。
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