The presented remobilization approach can be used for various indications such as arthrosis and arthritis as well as for traumatology.įinger joints are subject to constant stress in the form of pressure loads, such as when playing the piano, to extreme tensile and shear loads on the bone, such as in sports climbing. For the first time, the successful mapping of the process chain via a platform for finger joints opens the opportunity to maintain or restore the joint mobility required by the patient. Based on the transfer of data from 2D imaging procedures, implants are designed with osseointegrative surfaces, manufactured from customised materials using new near net shape and additive manufacturing methods, and tested mechanically and biologically in vivo. A central component is the use of artificial intelligence (AI) for the autogeneration of individualised implant designs from X-ray and computer tomography (CT) images of the patient. ![]() The research work undertaken for this purpose covers the entire process chain and concentrates on the reconstruction, development, manufacture, and clinical, standard-compliant implementation of individually manufactured ceramic implants using the finger joint as an example. Less than 20% of patients are pain-free and the complication rate is 40%. This contradicts the desire of all patients with rheumatoid arthritis to be able to move their wrists again. Until today, finger joint implants are therefore uncommon and stiffening surgical techniques are widespread. Studies from the 1960s showed increased loosening and breakouts in finger joint prostheses caused by inadequate material properties and lack of osseointegration. There is far less musculature to support the implants, so the risk of implant loosening is higher than with large implants. In contrast to the classical endoprostheses for the replacement of knee and hip joints, finger bones are much thinner. Challenges in the field of finger endoprostheses are the restoration of the morphology, mobility, stability and loading capacity, low bone loss during implantation, a stable and durable fixation at the bone, and wear-resistant sliding contact surfaces. ![]() Up to now, the possibilities of implant treatment and remobilisation in the area of small joints have been insufficient, as the design of the implants does not allow safe functionality due to their small size and high mechanical requirements. In Germany alone, at least five million people suffer from symptomatic arthrosis, and one and a half million people suffer from rheumatic diseases. The proposed method for individualized finger implant design and manufacturing may allow for correction of potential malpositions of the fingers in the future. Calculated fracture forces of the silicon nitride-based ceramic structure was validated by comparison of simulation and tests, and the calculation can be used as a quality index for training of artificial intelligence in the future. The model specimens are tested experimentally, and the loads are matched with a characteristic strength assuming a Weibull distribution of defects in the volume to generate and match failure probabilities. ![]() ![]() Using additive manufacturing with silicon nitride-based ceramics, model specimens and implants are produced via the lithography-based ceramic vat photopolymerisation process with full geometry or elements of triple periodic minimal surfaces structure. The 3D printing process and the structures used are evaluated via model tests and the final implant design via a reliability calculation in a way to ensure that this is also possible via an AI process in the future. Then, the individual implant design is derived from the finger model and 3D printed. Artificial intelligence-supported software is used to calculate three-dimensional models of the finger bones from two-dimensional X-ray images. In an automated process chain, implants will be produced from ceramic or metallic materials. When finger joints become immobile due to an accident during sports or a widespread disease such as rheumatoid arthritis, customised finger joint implants are to be created.
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