The replacement of arthritic small joints, such as the fingers and wrist, has typically involved the use of one-piece silicone rubber implants. Newer designs have involved the silicone moving against either a titanium or ultrahigh molecular weight polyethylene (UHMWPE) component. The aim of this study was to investigate the wear of medical grade silicone rubber against titanium and UHMWPE. A pin-on-disc apparatus was used to slide a titanium and UHMWPE pin against a silicone disc, in the presence of either a Ringer's solution or bovine serum lubricant. Testing was undertaken at a sliding speed of 0.079 m/s and was continued for 10 km. Wear factors for titanium against silicone were 40.0 x 10(-6) mm(3)/N m and 66.5 x 10(-6) mm(3)/N m for bovine serum and Ringer's solution, respectively. The wear factors for UHMWPE against silicone were higher with values of 84.4 x 10(-6) mm(3)/N m and 88.3 x 10(-6) mm(3)/N m for bovine serum and Ringer's solution, respectively. The results of this study will be useful in future designs of finger and wrist implants that combine silicone rubber with either titanium or UHMWPE.

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The metacarpophalangeal (MCP) joint is crucial for hand function, but is frequently affected by arthritis, leading to pain and disability. This paper reviews the biomechanics of the normal and diseased joint in order to help consider the design of improved MCP joint replacement implants. The normal MCP joint enables a large range of motion in flexion/extension and abduction/adduction as well as a few degrees of rotation. A normal joint typically allows 90° flexion, with a grip strength of up to 672 N. The diseased joint has a reduced range of motion (typically 30° flexion) and reduced hand strength compared to the normal joint. Current MCP joint replacement implants generally try to recreate the range of motion of the normal joint; however, many designs are prone to fracture, as they are unable to withstand the conditions of the diseased joint. It may be beneficial for future implant designs to provide just a functional range of motion. Future designs of MCP joint replacement implants need to be more durable and last longer. Careful consideration of the diseased joint, rather than the normal joint, may help to better define the requirements for such implants.

The metacarpophalangeal (MCP) joint is crucial for hand function, but the joints are frequently affected by arthritis, leading to pain and disability. Joint replacement implants are used to replace the diseased MCP joint. This paper presents an investigation of applying the soft layered concept in the design of a new MCP joint replacement implant. Analytical methods were used to investigate the minimum film thickness for a novel MCP joint with a soft layer. The effect of load, entraining velocity, radial clearance, radius of the metacarpal head, elastic modulus and thickness of the soft layer were investigated. The soft layered joints show an enhanced predicted film thickness and some evidence of fluid film lubrication that should help to reduce wear rates. It may be beneficial for future MCP joint implant designs to utilise the soft layered joint concept.