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Project title:
Defining in vivo kinematics of single piece silastic proximal inter phalangeal joint with magnetic resonance imaging
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Grant Holder: Mr Edward Jeans
Position: ST6 Trauma and Orthopaedics
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| Date Awarded |
30/11/2018 |
| Date of Report |
31/07/2019 |
| Grant Awarded |
£6,798 |
| Is this an interim or final report |
Interim |
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Summary of progress /findings (approx 300 words)
The full study protocol has been approved by the trust research department and REC review is scheduled for the 19.08.19. Protocol (PIPJ protocol V.3) and IRAS submission (FullDataset) attached with this email. As part of this a lead for each PIC has been identified and participating units are listed on the IRAS data set.
Patient information sheet (PIS silastic joint replacement) and consent form (09091 consent form) are also attached and these have been through trust patient review and approved for use.
We have assessed various designs for thermoplastic splints to hold the patients finger comfortably in position during the MRI scan to reduce movement artifact. Final design shown in images 1 - 4. I have also optimized the patient positioning and support as concurrent upper limb pathology is common in the study group.
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Images 1 -4: Custom thermoplastic splint
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I have also applied for and been accepted as a visiting fellow at Newcastle University School of Engineering (visiting fellowship), in order to access computer aided design and finite element software required measure displacement at the hinge / shoulder of the implant and movement of the implant relative to the bone.
Finally I have worked with the MRI technicians to establish a protocol for scan collection. This contains 0.5mm slices in the coronal, axial and sagittal planes. Example images shown below. The silastic joint replacements are shown in arthrogram solution as no in vivo examples are available on our trust PACS or in the literature. We are also able to perform a dynamic scan during pinch grip, which we hope will give valuable information as to the lateral load and deformation the implant experiences under normal conditions. We have now laid the ground work for the study and expect things to progress rapidly once REC approval in given in August. |
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Sample MRI images
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What is the relevance/value of this research to hand surgery?
Small joint arthroplasty remains a challenging area of hand surgery, with long term survivorship well below those of comparable hip and knee replacement. Defining how small joint arthroplasty behaves in vivo will inform future design work aiming to improve on patient outcomes and need for revision surgery.
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