TO FIX OR NOT TO FIX!? Strategies and tools to place and fixate a flexible joint implant

Osteoarthritis (OA) is a common form of degenerative arthritis primarily affecting joints like the knee, hand, and hip due to cartilage wear and tear. Hand OA, particularly, affects multiple hand joints, causing significant functional impairment, discomfort, and substantial economic costs related to diagnosis, treatment, and productivity losses. Surgical intervention becomes necessary when conservative treatments fail to alleviate hand OA symptoms, with various arthroplasty implants available for finger joints. However, complications like implant loosening and dislocation often occur, leading to limited improvement in overall outcomes despite advancements in joint prosthetic design.

The APRICOT® (Anatomically Precise Revolutionary Implant for bone Conserving Osteoarthritis Treatment) by Aurora Medical Ltd offers a groundbreaking solution for the challenges posed by existing finger joint implants for OA. This innovative implant, tailored for small joints affected by OA, features a self-lubricated polymeric sac mimicking natural joint characteristics. Unlike conventional implants, APRICOT® enables full joint range of motion through its unique internal motion design, supported by an internal lubricant coating. Currently in the proof-of-concept phase, APRICOT® aims to overcome significant challenges in OA treatment for small joints.

The thesis objectives include identifying the required anchoring systems for secure implant fixation, establishing effective implantation strategies, and designing and testing specialized surgical instruments. An innovative articulating joint distractor and specialized tweezers were developed for successful APRICOT® implantation. Strategies to ensure implant stability within the joint capsule were also explored, including mechanical options, adhesives, and coatings, with promising results from in vitro and in vivo assessments.